Isotretinoin & Nutrient Depletion
Also searched as Accutane, Amnesteem, Claravis. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Isotretinoin has been associated with depletion of ACETYL-L-CARNITINE, L-CARNITINE, PROPIONYL-L-CARNITINE and FOLIC ACID. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Isotretinoin long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Isotretinoin pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Isotretinoin
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
ACETYL-L-CARNITINE
Insignificant DepletionISOTRETINOIN (Accutane)
Data on the effects of isotretinoin on carnitine levels are conflicting. Reduced carnitine blood levels have been reported with the use of isotretinoin, sometimes with symptoms of carnitine deficiency, such as myalgia and muscle stiffness. However, other studies have found no significant effect of isotretinoin on carnitine blood levels. There is not enough information to recommend routine use of L-carnitine or acetyl-L-carnitine supplements with isotretinoin.
Acetyl-L-carnitine is a compound your muscles and nerves use for energy, and some studies have found that isotretinoin may be linked to lower carnitine levels in the blood, sometimes with muscle aches or stiffness. That said, other research found no meaningful change at all, so the picture is genuinely mixed. Given that this is rated as an insignificant depletion, most people taking isotretinoin do not need to worry about this or reach for a supplement. If you do notice unusual muscle discomfort while on isotretinoin, it is worth mentioning to your pharmacist or doctor.
Learn more about this nutrient: Acetyl-l-carnitine — uses, safety & interactions
References (2)
- Georgala S, Schulpis KH, Georgala C, Michas T. L-carnitine supplementation in patients with cystic acne on isotretinoin therapy. J Eur Acad Dermatol Venereol 1999;13:205-9. DOI
- Laker MF, Green C, Bhuiyan AK, Shuster S. Isotretinoin and serum lipids: studies on fatty acid, apolipoprotein and intermediary metabolism. Br J Dermatol 1987;117:203-6. PubMed
L-CARNITINE
Insignificant DepletionISOTRETINOIN (Accutane)
Reduced carnitine blood levels have been reported with the use of isotretinoin, sometimes with symptoms of carnitine deficiency, such as myalgia and muscle stiffness. However, other studies have found no significant effect of isotretinoin on carnitine blood levels. There is not enough information to recommend routine use of L-carnitine supplements with isotretinoin.
L-carnitine is a compound your body uses to turn fat into energy, and a few studies have noted lower carnitine blood levels in people taking isotretinoin, occasionally alongside muscle aches or stiffness. The leading theory is that isotretinoin may interfere with how the body produces or handles carnitine, though other studies found no meaningful change at all. Because the evidence is mixed and the rating is insignificant, most people on isotretinoin do not need to worry about this or take a supplement. If you have ongoing muscle discomfort while on isotretinoin, it is worth mentioning to your pharmacist or doctor.
What Carnitine does & food sources
Carnitine shuttles fatty acids into cells' mitochondria so they can be burned for energy.
Common food sources:
- Red meat (the richest source)
- Poultry and fish
- Dairy products
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Carnitine questions come up with specific medications (for example, valproic acid) and specific situations — this is a conversation for your prescriber, who can weigh testing or supplementation.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Carnitine supplements are usually reserved for clinician-identified situations rather than general use.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Learn more about this nutrient: L-carnitine — uses, safety & interactions
References (2)
- Georgala S, Schulpis KH, Georgala C, Michas T. L-carnitine supplementation in patients with cystic acne on isotretinoin therapy. J Eur Acad Dermatol Venereol 1999;13:205-9. DOI
- Laker MF, Green C, Bhuiyan AK, Shuster S. Isotretinoin and serum lipids: studies on fatty acid, apolipoprotein and intermediary metabolism. Br J Dermatol 1987;117:203-6. PubMed
PROPIONYL-L-CARNITINE
Insignificant DepletionISOTRETINOIN (Accutane)
Data on the effects of isotretinoin on carnitine levels are conflicting. Reduced carnitine blood levels have been reported, sometimes with symptoms of carnitine deficiency, such as myalgia and muscle stiffness. However, other studies have found no significant effect of isotretinoin on carnitine blood levels. There is not enough information to recommend routine use of L-carnitine or propionyl-L-carnitine supplements with isotretinoin.
Propionyl-L-carnitine is a compound your muscles use for energy, and some research has found that isotretinoin may be associated with lower carnitine levels in the blood, occasionally with muscle aches or stiffness. That said, other studies found no real change, and the evidence overall is conflicting and rated insignificant. For most people taking isotretinoin, this is not a practical concern, but if you develop unexplained muscle soreness during treatment, it is worth mentioning to your pharmacist or doctor.
Learn more about this nutrient: Propionyl-l-carnitine — uses, safety & interactions
References (2)
- Georgala S, Schulpis KH, Georgala C, Michas T. L-carnitine supplementation in patients with cystic acne on isotretinoin therapy. J Eur Acad Dermatol Venereol 1999;13:205-9. DOI
- Laker MF, Green C, Bhuiyan AK, Shuster S. Isotretinoin and serum lipids: studies on fatty acid, apolipoprotein and intermediary metabolism. Br J Dermatol 1987;117:203-6. PubMed
FOLIC ACID
Moderate DepletionRETINOIDS
Isotretinoin (Accutane), a retinoid vitamin A derivative, reduces serum levels of folic acid in patients with acne. Advise patients taking isotretinoin to maintain the recommended dietary intake of folic acid. For information on foods that are rich in folate, see our chart.
Folic acid is a B vitamin your body needs to build new cells and keep your DNA in good shape, and there is solid evidence that isotretinoin can pull serum folate levels down over time. Retinoids like isotretinoin appear to interfere with how the body processes and maintains folate, rather than simply blocking it from one spot in the gut. Because the rating here is moderate, this is worth taking seriously, especially for anyone on a longer course: making sure your diet includes plenty of folate-rich foods (leafy greens, beans, fortified cereals) is a reasonable first step. Ask your pharmacist or doctor whether your situation calls for anything beyond diet alone.
What Folic acid (folate) does & food sources
Folate is needed for cell division, red blood cell formation, and healthy fetal development.
Common food sources:
- Leafy green vegetables
- Beans, lentils, and peas
- Fortified grains and cereals
- Citrus fruits
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.
Learn more about this nutrient: Folic Acid — uses, safety & interactions
References (1)
- Javanbakht AM, Pour HM, Tarrahic MJ. Effects of oral isotretinoin on serum folic acid levels. J Drugs Dermatol. 2012;11(9):e23-4.
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Isotretinoin
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Isotretinoin & nutrients: FAQs
Does Isotretinoin deplete ACETYL-L-CARNITINE?
Should I take a supplement because I take Isotretinoin?
Should I stop taking Isotretinoin?
Where does this information come from?
Questions about Isotretinoin and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Isotretinoin are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.