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

Research output: Contribution to journalArticle

63 Scopus citations

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 - Jan 1 2004

Keywords

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

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

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    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. (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, 1033, 168-176. https://doi.org/10.1196/annals.1320.016