L-Carnitine supplementation reduces the general fatigue of cancer patients during chemotherapy

Abstract

L-Carnitine (LC) plays an important role in the metabolism of fatty acids, and LC deficiency is associated with a feeling of weakness or general fatigue. Cancer patients receiving chemotherapy often develop LC deficiency, which is considered to be a factor contributing to general fatigue. The aim of the present study was to evaluate the efficacy of LC supplementation as a treatment for general fatigue in cancer patients during chemotherapy. A total of 11 cancer patients who were suffering from general fatigue during chemotherapy in our hospital between September 2014 and December 2015 were examined (6 cases involved adjuvant chemotherapy and 5 cases involved chemotherapy for unresectable or recurrent disease). The patients were administered 1,500 mg/day of levocarnitine per os, and the change in mean daily fatigue from the baseline to 8 weeks was assessed using the Brief Fatigue Inventory. The change in the plasma levels of albumin and the lymphocyte counts from the baseline to 8 weeks were also assessed. LC supplementation reduced general fatigue in all cases. Moreover, LC supplementation maintained the plasma levels of albumin and lymphocyte counts during chemotherapy, and enabled patients to continue chemotherapy sequentially without dose reduction. Therefore, LC supplementation improved general fatigue in all the examined cancer patients during chemotherapy. This treatment may make improve the tolerability of chemotherapy in cancer patients by reducing general fatigue and improving the nutritional status.

Carnitine and Depression

“…The symptoms of these diseases are improved after carnitine supplementation ( 21 ). For cancer patients, the probability of carnitine deficiency has shown to be very high ( 22 ). A research showed that L-carnitine supplementation was safe and might have beneficial effects on fatigue, depressive symptoms and sleep quality in cancer patients ( 23 ).…”

Can l-carnitine reduce post-COVID-19 fatigue?

“…Carnitine supplementation is actively used for the treatment of CFS, fatigue caused by chemotherapy, fatigue in the elderly, and fatigue caused by different neurological diseases [ 19 ]. Supplementation of carnitine is reported to reduce cancer-related fatigue [ 11 , 20 ]. Patients with chronic hepatitis, when treated with l -carnitine along with interferon-gamma and ribavirin also show improvement in fatigue, absenteeism, presenteeism and work-related productivity [ 21 ].…”

“…Suggested mechanisms for fatigue include imbalances in energy production caused by increased energy requirement (e.g., caused by tumor growth, infection, fever, or surgical procedures), reduced availability of substrates (e.g., due to anorexia, nausea, or vomiting), atypical generation of compounds that disrupt metabolic homeostasis or regular functions of muscles (e.g., cytokines and proteolysis inducers), anemia, and hypoxemia. Further proposed processes associate fatigue with the pathophysiology of sleep disturbance and depression [ 11 ]. An animal-model based study showed that treatment of rats with l -carnitine against muscular fatigue reduces free-radical mediated oxidative stress by reducing the production of thiobarbituric acid reactive substances, protein carbonyl, creatine kinase and lipid hydroperoxide [ 26 ].…”

“…l -Carnitine is a trimethylated amino acid that is structurally similar to choline and is needed as a cofactor to convert long-chain free fatty acids to acylcarnitine and transfer them to the mitochondrial matrix [ 11 ]. Therefore, this compound plays a major role in the metabolism of fatty acids and its inadequacy will induce feelings of tiredness or general fatigue [ 6 ].…”

Meta-Analysis of Pharmacological, Nutraceutical and Phytopharmaceutical Interventions for the Treatment of Cancer Related Fatigue

“…The most investigated medications among them include psychostimulants, ginseng, corticosteroids, megestrol, mistletoe, guarana, antidepressants specifically selective serotonin receptor reuptake inhibitors (SSRI's). Other agents investigated include Hemopoietin agents [13], Donepezil [14], Testosterone [15,16], Omega 3 polyunsaturated fatty acids [17][18][19], L-carnitine [20][21][22], Astragalus membranaceus [23], Ashwagandha [24], Thyrotropin releasing hormone [25], Microbiome [26], Coenzyme Q10 [27], Micro and macronutrients supplementation such as protein rich diet, vitamin or mineral supplementation [28], and others [29][30][31][32].…”