L-Carnitine in the treatment of fatigue in adult celiac disease patients: a pilot study.

Abstract

BACKGROUND:

Fatigue is common in celiac disease. L-Carnitine blood levels are low in untreated celiac disease. L-Carnitine therapy was shown to improve muscular fatigue in several diseases.

AIM:

To evaluate the effect of L-carnitine treatment in fatigue in adult celiac patients.

METHODS:

Randomised double-blind versus placebo parallel study. Thirty celiac disease patients received 2 g daily, 180 days (L-carnitine group) and 30 were assigned to the placebo group (P group). The patients underwent clinical investigation and questionnaires (Scott-Huskisson Visual Analogue Scale for Asthenia, Verbal Scale for Asthenia, Zung Depression Scale, SF-36 Health Status Survey, EuroQoL). OCTN2 levels, the specific carnitine transporter, were detected in intestinal tissue.

RESULTS:

Fatigue measured by Scott-Huskisson Visual Analogue Scale for Asthenia was significantly reduced in the L-carnitine group compared with the placebo group (p=0.0021). OCTN2 was decreased in celiac patients when compared to normal subjects (-134.67% in jejunum), and increased after diet in both celiac disease treatments. The other scales used did not show any significant difference between the two celiac disease treatment groups.

CONCLUSION:

L-Carnitine therapy is safe and effective in ameliorating fatigue in celiac disease. Since L-carnitine is involved in muscle energy production its decreased absorption due to OCTN2 reduction might explain muscular symptoms in celiac disease patients. The diet-induced OCTN2 increase, improving carnitine absorption, might explain the L-carnitine treatment efficacy.

• Authors: C Ciacci, G Peluso, E Iannoni, M Siniscalchi, P Iovino, A Rispo, R Tortora, C Bucci, F Zingone, S Margarucci, M Calvani
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 39 Issue 10 Pg. 922-8 (Oct 2007) ISSN: 1590-8658 [Print] Netherlands
• PMID: 17693145 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Biomarkers
• Organic Cation Transport Proteins
• SLC22A5 protein, human
• Solute Carrier Family 22 Member 5
• Vitamin B Complex
• Carnitine

Topics

• Administration, Oral
• Adult
• Biomarkers (metabolism)
• Biopsy
• Carnitine (administration & dosage, pharmacokinetics, therapeutic use)
• Celiac Disease (complications, diagnosis, drug therapy)
• Chromatography, High Pressure Liquid
• Dose-Response Relationship, Drug
• Double-Blind Method
• Electrophoresis, Polyacrylamide Gel
• Fatigue (blood, drug therapy, etiology)
• Female
• Follow-Up Studies
• Humans
• Jejunum (metabolism, pathology)
• Male
• Organic Cation Transport Proteins (metabolism)
• Pilot Projects
• Quality of Life
• Solute Carrier Family 22 Member 5
• Surveys and Questionnaires
• Treatment Outcome
• Vitamin B Complex (administration & dosage, pharmacokinetics, therapeutic use)