Written by Peter Renner, Markus Horneber and the CAM-Cancer Consortium.
Updated January 29, 2015

L-Carnitine

Does it work?

Please see Table 1 for details of clinical trials of LC, ALC and PLC.

Cancer-related fatigue

There is evidence from four recent randomized trials (RCTs), involving >800 participants with sufficiently robust measures of CrF that LC does not reduce moderate to severe CrF(35-37) or that ALC prevents from CrF occurring during taxane-based chemotherapy.(38)These findings contradict those from several uncontrolled studies suggesting that L-carnitine (LC) might help against CrF. (32-34)

Cancer anorexia-cachexia syndrome

There is evidence that LC has beneficial effects on parameters related to CACS, based on the results from one RCT (n=72) (36) and a prospective, uncontrolled study including 12 patients with advanced cancers (32).

Sexual dysfunction

The evidence that ALC and PLC could prevent sexual dysfunction in patients after prostatectomy comes from one RCT (39) which has been included and assessed in a Cochrane review on the effectiveness of interventions for sexual dysfunction. The review authors conclude that: ‘(...)there is some evidence suggestive that PDE5 [phosphodiesterase-inhibitor-5] inhibitors are more effective in combination with acetyl-L-carnitine and propionyl-L-carnitine.’(40)

Chemotherapy-induced peripheral neuropathy

There is evidence from two prospective, uncontrolled studies including 52 patients with different grades of CIPN that ALC is beneficial in the treatment of paclitaxel- and cisplatinum-induced peripheral neuropathy. (41, 42)

Evidence that ALC or LC might protect from CIPN comes from two RCTs and is contradictory. The findings from the most recent trial, including 409 women receiving adjuvant taxane-containing chemotherapy, introduce a note of caution in that there are indications that ALC could even increase CIPN.(38) The author of a review mentions, however, an unpublished ‘double-blind, placebo-controlled, multicentre trial on 119 cancer patients treated with taxol alone or in combination with other neurotoxic or non-neurotoxic drugs’ in which ‘significant action of AL-carnitine [Acetyl-L-carnitine] in improving vibratory sensation in patients with CIPN, compared with placebo’ was found.(43)

Cardiotoxicity

Waldneret al. found no evidence that LC protects against anthracyclin-related cardiotoxicity in an RCT involving 40 lymphoma patients (44), while Lissoniet al. found evidence that LC prevented cardiac adverse effects when high-dose interleukin-2 was used in an RCT with 30 patients.(45)

Citation

Peter Renner, Markus Horneber, CAM-Cancer Consortium. L-Carnitine [online document]. http://cam-cancer.org/The-Summaries/Dietary-approaches/L-Carnitine. January 29, 2015.

Document history

Assessed as up to date in January 2015 by Barbara Wider.
Summary fully updated and revised in July 2014 by Peter Renner and Markus Horneber.
Summary first published in September 2012, authored by Peter Renner and Markus Horneber.

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