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Carnitine may be useful for cancer-related fatigue
NEW YORK (Reuters Health) - L-carnitine supplementation at up to 3 grams per day is safe and well-tolerated in cancer patients, and relieves cancer-related fatigue, according to a report in the Journal of Pain and Symptom Management.
Investigators at Beth Israel Medical Center in New York, New York, led by Dr. Ricardo A. Cruciani, studied 27 carnitine-deficient cancer patients, randomly selected to receive carnitine supplements in doses up to 3 grams per day for 7 days.
Patients completed questionnaires on fatigue, depression and quality of sleep and were scored for function on Karnofsky Performance Status scale, before and after carnitine supplementation.
There were no side effects, even at the highest dose, Cruciani told Reuters Health. As anticipated, use of the supplements was associated with a marked increase in blood carnitine levels.
Fatigue decreased significantly with carnitine supplementation, but without a significant effect on sleep quality. "There is a high variability in the literature in carnitine doses used in studies," Cruciani said. "Doses are being administered empirically ... We found that the effect plateaued at about 2 to 3 grams a day for fatigue."
There are a number of causes for fatigue with cancer, Cruciani noted. "It can be related to chemotherapy or radiation therapy, to anemia or from metabolic causes ... Cancer patients don't use fuel properly."
Carnitine is a micronutrient found in meat and dairy products, he explained. Certain chemotherapeutic agents, such as cisplatin, specifically impair carnitine reabsorption by the kidney. Carnitine deficiency is found in about half of cancer patients, Cruciani said.
He commented that a trial of carnitine supplementation in cancer patients or patients with other chronic illnesses and severe fatigue is about to begin. This study should definitively determine if carnitine is useful for cancer-related fatigue, Cruciani concluded.
SOURCE: Journal of Pain and Symptom Management, December 2006.
Reuters Health