MIC is an acronym for L-Methionine, Inositol, and Choline. Each of the individual MIC components are called lipotropic agents. They are believed to work synergistically to help with the breakdown of fat during metabolism in the body. They have also been shown to be of benefit in the removal of fats from the liver.
While researchers recognize the role of lipotropics in fat metabolism, specifically in the liver, there is no substantial published evidence that MIC-L-Carnitine injection will help patients lose weight. Most research on the mechanics of lipotropics is very old and the majority of research was performed on rodents.1, 2, 3, 4 Nevertheless, lipotropic agents may be prescribed in combination with a healthy diet, exercise regimen, and routine counseling sessions as part of a medically-guided weight loss plan. Injections are often administered once to twice weekly by a health care provider.
Methionine is one of nine essential amino acids, meaning it cannot be synthesized by the body and must be obtained within the diet or as a supplement. Dietary sources of methionine include meats, dairy products, spinach, potatoes, Brazil nuts, and sesame seeds.5, 6
Methionine plays a role in various processes in the body including:
- The production of L-cysteine, carnitine, adrenaline, choline, melatonin, etc.
- The production of lecithin in the liver, thereby helping to lower serum cholesterol levels and process fatty acids.
- The donation of sulfur to support the development of nails and hair growth.
- The donation of methyl groups to histones that activate certain genetic processes that may be involved in the increase in lean tissue.
- The increase in CNS activity (and therefore caloric requirements of the CNS).
- The excretion of heavy metals through chelation.
- The protection against hepatotoxins such as acetaminophen.7, 8, 9, 10
Inositol is a sugar alcohol produced by the liver and kidneys. It was once believed to be a type of B vitamin. It is also found in beans, fruits, and peanuts. Inositol has been found to decrease fatty acid synthesis by preventing the enzymes responsible for the production of triglycerides that reside in body fat. It also acts as a second messenger for hormones such as insulin and follicle stimulating hormone.10, 11, 12, 13 Additionally, inositol may be effective in reducing insulin resistance, a condition where the body is resistant to insulin and exhibits increased body fat.14
It has been found to work synergistically with choline and displays heightened lipotropic actions than when given alone.15
Choline is a nutrient responsible for a number of metabolic pathways in the human body. While it is produced in the liver, it is still considered an essential dietary nutrient because the amount produced is not enough to meet the body’s needs. Soybeans, eggs, beef liver, cauliflower, tofu and almonds are food sources rich in choline.
Choline plays a role in various processes in the body including:
- The mobilization of fatty acids and prevention of their deposition in a given part of the body.
- The production of sphingomyelin and phosphatidylcholine (needed for cell membrane integrity).
- It is a precursor to acetylcholine, a neurotransmitter that allows communication between neurons, muscular contraction and function, and increased CNS activity.
- The modulation of gene expression and cell membrane signaling.
- Fetal brain development.15, 16, 17
Levocarnitine is a substance produced by the liver from the amino acids methionine and lysine and found naturally in mammalian muscle. It is required in the conversion of macronutrients into cellular energy. Levocarnitine acts by transporting fatty acids to the location within the mitochondria to be broken down and used as energy. Research suggests choline supplementation may increase the utilization of carnitine as well as the removal of fatty acids, thereby reducing serum and urinary carnitine levels.18 Therefore, those taking MIC injections may find benefit with the addition of L-carnitine as a means of maintaining adequate levels of the substance. Levocarnitine has also been used clinically in the treatment of primary and secondary carnitine deficiency, Alzheimer’s disease, dilated cardiomyopathy, valproic acid-induced hepatotoxicity, and hyperlipoproteinemia.19
Since MIC molecules are closely related to the B-vitamins, the MIC-L-Carnitine injection may be given together with vitamin B12 (and/or other B-vitamins) to enhance the lipotropic effects and to increase the perception of well-being and energy.20
Levocarnitine, a version of carnitine, is FDA approved as oral and injectable prescription products.21, 22 D,L-Carnitine is also available as a dietary supplement. While levocarnitine is commercially available in oral tablets and solutions as well as injectable solutions, MIC-L-Carnitine Injection is not commercially available at this time.
Patients that would benefit from its administration may be prescribed MIC-L-Carnitine Injection as determined by a health care provider. The most popular formulation compounded at Galleria Medical Pharmacy is Methionine 15 mg/mL / Inositol 50 mg/mL / Choline Chloride 50 mg/mL / L-Carnitine 50 mg/mL Injectable Solution, though other strengths and formulations may be available upon request.
For best results, MIC-L-Carnitine Injection should be administered at regular intervals under professional supervision by a healthcare practitioner and in combination with a healthy diet, exercise regimen, and routine counseling sessions. As per FDA regulations, compounds prepared by a pharmacy are not intended for office use (e.g., office stock of a drug that is administered to multiple patients). As such, this preparation requires a prescription, which is then administered to the specified patient by a healthcare practitioner at their practice.
Store this medication at 36°F to 46°F (2°C to 8°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.
- McHenry EW, Patterson JM. Lipotropic Factors. Physiological Reviews. 1944 Jan; 24(1): 128-167.
- Sellers EA, et al. The Lipotropic Factors in Experimental Cirrhosis. British Medical Journal. 1948 Jun; 1061-1065.
- Institute of Medicine (US) Committee on Military Nutrition Research; Marriott BM, editor. Food Components to Enhance Performance: An Evaluation of Potential Performance-Enhancing Food Components for Operational Rations. Washington (DC): National Academies Press (US); 1994. 19, Choline: Human Requirements and Effects on Human Performance.
- Anthony Fardet & Jean-Michel Chardigny (2013) Plant-Based Foods as a Source of Lipotropes for Human Nutrition: A Survey of In Vivo Studies, Critical Reviews in Food Science and Nutrition, 53:6, 535-590
- Lopez, M.J., Mohiuddin, S.S, “Biochemistry, Essential Amino acids”, StatPearls. April 2020. Available: https://www.ncbi.nlm.nih.gov/books/NBK557845/
- Parkhitko, A.A., Jouandin, P., Mohr, S.E., Perrimon, N.,” Methionine metabolism and methyltransferases in the regulation of aging and lifespan extension across species”, Aging Cell, vol.18 issue 6. December 2019. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826121/
- “What is methionine?”, amino acid studies. Available: https://aminoacidstudies.org/l-methionine/
- “Methionine”, Drug Bank. Available: https://go.drugbank.com/drugs/DB00134
- Best CH, Ridout JH. “The Lipotropic Action of Methionine”. Journal of Physiology. 3 Oct 1939;97:489-494.
- Young, S.N. and M. Shalchi, The effect of methionine and S-adenosylmethionine on S-adenosylmethionine levels in the rat brain. J Psychiatry Neurosci, 2005. 30(1): p. 44-8.
- Formoso, G., Baldassarre, M.P.A., Ginestra, F., Carlucci, M.A., Bucci, I., Consoli, A., “Inositol and antioxidant supplementation: Safety and efficacy in pregnancy”, Diabetes/Metabolism Research and Reviews, vol.35 issue 5. July 2019. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617769/
- Hallman, M, “Inositol During Perinatal Transition”, Neoreviews. Vol.16 issue 2. February 2015. Available: https://neoreviews.aappublications.org/content/16/2/e84
- “Inositol”, Drug Bank. Available: https://go.drugbank.com/drugs/DB13178
- Corrado, F., et al., The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med, 2011. 28(8): p. 972-5.
- Gavin G, Patterson J, McHenry W. ” Comparison of the Lipotropic Effects of Choline, Inositol, and Lipocaic in Rats”. Journal of Biochemistry. 29 Jan 1943;148:275-279.
- Korsmo, H.W., “Choline: Exploring the Growing Science on its Benefits for Moms and Babies”, Nutrients, vol.11 issue 8. August 2019. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722688/#:~:text=The%20choline%20adequate%20intake%20(AI,day%20during%20lactation%20%5B3%5D.
- “Choline”, Fact Sheet for Health Professionals. Available: https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/#h8
- Hongu, N. and D.S. Sachan, Carnitine and choline supplementation with exercise alter carnitine profiles, biochemical markers of fat metabolism and serum leptin concentration in healthy women. J Nutr, 2003. 133(1): p. 84-9.
- Brass EP. Supplemental carnitine and exercise. Am J Clin Nutr 2000;72(suppl):618S-623S.
- Solomon L. “Disorders of cobalamin (Vitamin B12) metabolism: Emerging concepts in pathophysiology, diagnosis and treatment”. Elsevier Review. 1-15. Web.
- Carnitor (levocarnitine) injection package insert. Gaithersburg, MD: Sigma Tau Pharmaceuticals; 2015 Apr.
- Carnitor (levocarnitine) tablets, oral solution, and sugar-free oral solution package insert. Gaithersburg, MD: Sigma Tau Pharmaceuticals; 2015 Apr.
Compounding Pharmacy Statement
This preparation is compounded with drug components whose suppliers are registered with the FDA. While Galleria Medical Pharmacy adheres to USP <797> guidelines and applicable state and federal regulations to meet the required quality standards, the statements made regarding this preparation have not been evaluated by the FDA for safety or clinical effectiveness. As such, this preparation is not intended to diagnose, treat, cure, or prevent any disease. For inquiries concerning this preparation, please contact (504) 267-9876.