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L-Acetylcarnitine is a endogenous substance, synthesized in the mitochondria, that increases cellular oxidative metabolism and cholinergic activity. It has a good penetration in the CNS when administered orally and intravenously, and no side effects have been observed.
L-Acetylcarnitine has a large variety of interesting pharmacological properties:
It is a cholinergic agent because it promotes the synthesis and freeing of acetylcholine.
It reduces oxidation processes, thus reducing lipofuscin deposits in the brain.
It acts on the hypothalamic-hypophyseal-adrenal axis, antagonizing the existing downregulation (Carta and Calvani 1991).
In a 1-year study of 130 patients with AD (63 in treatment with L-acetylcarnitine and 67 with placebo), an improvement in the cognitive decline measured through neuropsychiatric batteries was observed (Spagnoli et al. 1991).

Acetylcarnitine may be a useful for treatment of male infertility caused by low quantities of immobile sperm.
Acetyl-L-carnitine (ALC) is produced naturally in humans, and can be found in the brain, liver, and kidneys. ALC is also available as a dietary supplement. ALC has been studied for its potential use in slowing the progression of age-related memory loss and Alzheimer’s disease. ALC may also have a potential use in the treatment of neuropathy (nerve pain) associated with diabetes and HIV disease.

ChEBI: An O-acyl-L-carnitine where the acyl group specified is acetyl. It facilitates movement of acetyl-CoA into the matrices of mammalian mitochondria during the oxidation of fatty acids.

Human Endogenous Metabolite