RCW Vermeulen*, RM Kurk*, HR Scholte**
*CFS Research Center Amsterdam,
**Erasmus University Rotterdam,
CFS Research Center Amsterdam,
Waalstraat 25, 1078 BR
Carnitine, Acetylcarnitine and Propionylcarnitine in the Treatment of Chronic Fatigue Syndrome
We treated 150 patients with complaints of Chronic Fatigue Syndrome (CFS, CDC 1994 criteria) in an open label study with 1g oral L-carnitine bid. After 6 months 104 patients (69%) reported improvement of symptoms of fatigue, cognition and/or pain.
Another 18 CSF-patients were included in a randomised double blind study. Six were treated with oral acetyl-L-carnitine 1g/d plus L-carnitine 1g/d, 6 received twice the dosage and 6 placebo. After 6 months major improvement was reported by 4 patients in the low dosage group, none in the high dosage group and 1 in the placebo group.
We included 90 CFS-patients in an open study of acetyl-L-carnitine 1g bid, propionyl-L-carnitine 1g bid or both. The endpoints of the study were the Clinical Global Impression (CGI), fatigue score (MFI-20), cognition (Stroop) and pain (MPQ-DLV). At screening, patients complaints and cognitive performance were assessed. This was repeated after 2 months no-treatment period, then patients were randomly distributed in 3 groups and treated for 6 months. Two weeks after the last visit in the treatment period, patients were seen for follow up.
In the no-treatment period 15% improved (CGI). After treatment for 6 months 61% improved in the single, low dosage groups and 36% in the double, high dosage group (p= 0.05). The improvement after 6 months was significant in all groups for the CGI, the fatigue score and the Stroop test (p<0.05).
Plasma free-carnitine levels at randomisation correlated positively with clinical improvement (DCGI, p=0.013; D fatigue-score, p=0.008).
At follow up, 52% of patients in the low dose and 41% in the high dose group had a relapse of CFS.
These studies indicate that L-carnitine, acetyl-L-carnitine and propionyl-L-carnitine are successful for the treatment of symptoms of chronic fatigue syndrome in a major subset of patients.
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