Acetyl L-Carnitine (ALC) for CFS, Cancer Related Fatigue and Fibromyalgia

We have long known that people with CFS and Fibromyalgia are low in Acetyl L-Carnitine and that supplementation helps.^1,2 A new study has now also found that ALC helps pain and depression in fibromyalgia and even helps cancer related fatigue. Take Acetyl L-Carnitine 500 mg twice a day for at least 4 months. Higher doses are actually less effective. Taking plain Carnitine (as opposed to Acetyl L-Carnitine) is not effective as it does not get into your cells mitochondria (energy furnaces) properly.

A new study showed that taking Acetyl L-Carnitine 500 mg 3x day significantly improved overall well being and decreased pain and depression in Fibromyalgia.

New Study

Objective: Fibromyalgia (FMS) is a chronic syndrome characterized by widespread pain, troubled sleep, disturbed mood, and fatigue.

Several analgesic strategies have been evaluated but the results are moderate and inconsistent. Antidepressant agents are now considered the treatment of choice in most patients.

It has been recently suggested that FMS may be associated with metabolic alterations including a deficit of carnitine.

In this multicenter randomized clinical trial we evaluated the efficacy of Acetyl L-Carnitine (ALC) in patients with overt FMS.

Methods: 102 patients meeting the American College of Rheumatology criteria for FMS were randomized into the study. The treatment consisted of 2 capsules/day of 500 mg ALC or placebo plus one intramuscular (i.m.) injection of either 500 mg ALC or placebo for 2 weeks. During the following 8 weeks the patients took 3 capsules daily containing either 500 mg ALC or placebo. The patients were seen during treatment after 2 (visit 3), 6 (visit 4) and 10 weeks (visit 5). The patients were also visited 4 weeks after treatment discontinuation (follow-up visit).

Outcome measures included the number of positive tender points, the sum of pain threshold (kg/cm**2 or "total myalgic score"), the Short Form 36 (SF36), a 100 mm visual analog scale (VAS) for self-perceived stiffness, fatigue, tiredness on awakening, sleep, work status, depression, and muscular-skeletal pain, and the Hamilton depression scale.

Results: The "total myalgic score" and the number of positive tender points declined significantly and equally in both groups until the 6th week of treatment. At the 10th week both parameters remained unchanged in the placebo group but they continued to improve in the ALC group with a statistically significant between-group difference.

Most VAS scores significantly improved in both groups.

A statistically significant between-group difference was observed for depression and musculo-skeletal pain. Significantly larger improvements in SF36 questionnaire were observed in ALC than in placebo group for most parameters. Treatment was well-tolerated.

Conclusion: Although this experience deserves further studies, these results indicate that ALC may be of benefit in patients with FMS, providing improvement in pain as well as the general and mental health of these patients.

References

1. A.V. Plioplys and S. Plioplys, "Amantadine and L-Carnitine Treatment of Chronic Fatigue Syndrome," Neuropsychobiology 35 (1) (1997): 16-23.
2. H. Kuratsune, K. Yamaguti, M. Takahashi, et al., "Acylcarnitine Deficiency in Chronic Fatigue Syndrome," Clinical Infectious Disease 18 (3 Supplement 1) (January 1994): S62-S67.

• Double-blind, multicenter trial comparing Acetyl-L-Carnitine with placebo in the treatment of fibromyalgia patients. M Rossini, O Di Munno, G Valentini, G Bianchi, G Biasi, E Cacace, D Malesci, G La Montagna, O Viapiana, and S Adami Clin Exp Rheumatol, March 1, 2007; 25(2): 182-8.