Sunday, April 10, 2011

L-carnitine deficiency in CFS

Note: As always disease stage and subgrouping impact study results.
Fatigue scales are also tricky. According to CFS research Leonard
Jason the FSS scale is far more accurate than the Chalder scale with
has a ceiling effect which does not measure the severity of post
exertional malaise.

Any dietary supplements taken should always be reported to one's
physician or pharmacist to make sure they are not contraindicated for
use with other supplements or prescription medications also taken.

J Intern Med. 2010 Dec 22. doi: 10.1111/j.1365-2796.2010.02341.x.
[Epub ahead of print]

Long-chain acylcarnitine deficiency in chronic fatigue syndrome
patients. Potential involvement of altered carnitine
palmitoyltransferase-I activity.

Reuter SE, Evans AM.
School of Pharmacy & Medical Sciences Sansom Institute for Health
Research, University of South Australia, Adelaide, SA, AUSTRALIA.


Objective.  The underlying aetiology of chronic fatigue syndrome is
currently unknown; however, in light of carnitine's critical role in
mitochondrial energy production, it has been suggested that chronic
fatigue syndrome may be associated with altered carnitine homeostasis.
This study was conducted to comparatively examine full endogenous
carnitine profiles in chronic fatigue syndrome patients and healthy

Design.  A cross-sectional, observational study.

Setting and subjects.  Forty-four patients with chronic fatigue
syndrome and 49 age- and gender-matched healthy controls were
recruited from the community and studied at the School of Pharmacy &
Medical Sciences, University of South Australia.

Main outcome measures.  All participants completed a fatigue severity
scale questionnaire and had a single fasting blood sample collected
which was analysed for L-carnitine and 35 individual acylcarnitine
concentrations in plasma by LC-MS/MS.

Results.  Chronic fatigue syndrome patients exhibited significantly
altered concentrations of C8:1, C12DC, C14, C16:1, C18, C18:1, C18:2
and C18:1-OH acylcarnitines; of particular note, oleyl-L-carnitine
(C18:1) and linoleyl-L-carnitine (C18:2) were, on average, 30-40%
lower in patients than controls (p<0.0001).
Significant correlations between acylcarnitine concentrations and
clinical symptomology were also demonstrated.

Conclusions. It is proposed that this disturbance in carnitine
homeostasis is a result of a reduction in carnitine
palmitoyltransferase-I (CPT-I) activity, possibly due to the
accumulation of omega-6 fatty acids previously observed in this
patient population.

It is hypothesised that the administration of omega-3 fatty acids in
combination with L-carnitine would increase CPT-I activity and improve
chronic fatigue syndrome symptomology.

Copyright © 2010 The Association for the Publication of the Journal of
Internal Medicine.

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