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Fatigue for Cancer Chemotherapy ? Take L-Carnitine as Nutritional Supplement

Chemotherapy works by killing rapidly dividing cells. These cells include cancer cells, which continuously divide to form more cells, and healthy cells that divide quickly, such as those in your bone marrow, gastrointestinal tract, reproductive system and hair follicles. Healthy cells usually recover shortly after chemotherapy is complete, so for example, your hair starts growing again.Because chemotherapy drugs can affect healthy cells, one of their disadvantages is that you may experience side effects, some temporary and some longer term. Not every drug will cause every side effect. Your doctor can tell you what to expect from the drugs you're receiving.

If your doctor recommends chemotherapy to you, you may feel anxious. But by becoming informed about chemotherapy — what it is, why and how it's used, and what you can expect — you may feel more comfortable with the treatment process.People with cancer are at risk for developing nutritional deficiencies.There are several factors that may contribute to the type and degree of nutrient deficiencies:

The primary organ where the malignancy occurs
The severity of the cancer at the time of diagnosis
The symptoms experienced by the person with cancer
The type and frequency of the cancer treatment being used and the side effects associated with that treatment (surgery, radiation, or chemotherapy)
The effect of the malignancy or disease on food and nutrient ingestion, tolerance, and utilization

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, 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.

Carnitine, also known as L-carnitine (levocarnitine) is a quaternary ammonium compound synthesized from the amino acids lysine and methionine and is responsible for the transport of fatty acids from the cytosol into the mitochondria. It is often sold as a nutritional supplement. Originally found as a growth factor for mealworms and labeled vitamin Bt.

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.

The best source of natural carnitine is in red meat and dairy products. Other natural sources of Carnitine include nuts and seeds (e.g pumpkin, sunflower, sesame), legumes or pulses (beans, peas, lentils, peanuts), vegetables (artichokes, asparagus, beet greens, broccoli, brussels sprouts, collard greens, garlic, mustard greens, okra, parsley), fruits (apricots, bananas), cereals (buckwheat, corn, millet, oatmeal, rice bran, rye, whole wheat, wheat bran, wheat germ) and other 'health' foods (bee pollen, brewer's yeast, carob, and kale).