L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency: A preliminary analysis

R. A. Cruciani, E. Dvorkin, P. Homel, B. Culliney, S. Malamud, L. Shaiova, S. Fleishman, J. Lapin, E. Klein, P. Lesage, R. Portenoy, N. Esteban-Cruciani

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Abstract

Nutritional factors are among the postulated causes of fatigue, a highly prevalent symptom in the cancer population, with serious impact on patients' quality of life. Deficiency of the micronutrient carnitine may play a role by reducing energy production through fatty acid oxidation. We present preliminary data of an open-label, dose-finding study to determine safety and maximally tolerated dose (MTD) of 1 week of L-carnitine supplementation in cancer patients with fatigue and carnitine deficiency. Patients who met inclusion/exclusion criteria underwent carnitine level determination. Eighty-three percent of these patients (15/18) had carnitine deficiency. Preliminary data analysis of 13 patients showed that total carnitine increased from 30.0 ± 6.9 to 41.0 ± 12.1 (mean ± SD) after 1 week of supplementation (P = 0.01), and free carnitine increased from 24.3 ± 6.1 to 33.8 ± 9.8 (P = 0.004). Outcome measures were fatigue (BFI score), depression (CES-D), sleep disruption (ESS), and performance status (Karnofsky). Median (min, max) BFI score at baseline was 73 (46, 82) versus 50 (3, 82) after 1-week supplementation (P = 0.009). CES-D score at baseline was 29 (16, 42) and 22 (8, 32) after 1 week (P = 0.028). ESS at baseline was 46.5 (0, 69) and 30.4 (0, 72) after 1 week (P = 0.015). Karnofsky score did not change significantly (P = 0.38). We are currently conducting a randomized, double-blind, placebo-controlled study to rigorously assess the role of L-carnitine for the treatment of fatigue and depression in cancer patients.

Original languageEnglish (US)
Pages (from-to)168-176
Number of pages9
JournalAnnals of the New York Academy of Sciences
Volume1033
DOIs
StatePublished - 2004

Fingerprint

Carnitine
Fatigue
Fatigue of materials
Neoplasms
Therapeutics
Depression
Karnofsky Performance Status
Maximum Tolerated Dose
Cancer Patients
Mood
Micronutrients
Labels
Sleep
Fatty Acids
Placebos
Quality of Life
Outcome Assessment (Health Care)
Safety
Oxidation
Dose

Keywords

  • Cancer patients
  • Carnitine deficiency
  • Depression
  • Fatigue
  • L-carnitine
  • Supplementation

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency : A preliminary analysis. / Cruciani, R. A.; Dvorkin, E.; Homel, P.; Culliney, B.; Malamud, S.; Shaiova, L.; Fleishman, S.; Lapin, J.; Klein, E.; Lesage, P.; Portenoy, R.; Esteban-Cruciani, N.

In: Annals of the New York Academy of Sciences, Vol. 1033, 2004, p. 168-176.

Research output: Contribution to journalArticle

Cruciani, RA, Dvorkin, E, Homel, P, Culliney, B, Malamud, S, Shaiova, L, Fleishman, S, Lapin, J, Klein, E, Lesage, P, Portenoy, R & Esteban-Cruciani, N 2004, 'L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency: A preliminary analysis', Annals of the New York Academy of Sciences, vol. 1033, pp. 168-176. https://doi.org/10.1196/annals.1320.016
Cruciani, R. A. ; Dvorkin, E. ; Homel, P. ; Culliney, B. ; Malamud, S. ; Shaiova, L. ; Fleishman, S. ; Lapin, J. ; Klein, E. ; Lesage, P. ; Portenoy, R. ; Esteban-Cruciani, N. / L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency : A preliminary analysis. In: Annals of the New York Academy of Sciences. 2004 ; Vol. 1033. pp. 168-176.
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T2 - A preliminary analysis

AU - Cruciani, R. A.

AU - Dvorkin, E.

AU - Homel, P.

AU - Culliney, B.

AU - Malamud, S.

AU - Shaiova, L.

AU - Fleishman, S.

AU - Lapin, J.

AU - Klein, E.

AU - Lesage, P.

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