I've read that the dietary supplement acetyl-L-carnitine may reduce fatigue in multiple sclerosis. Is this true?
Answer From Iris Marin Collazo, M.D.
Currently, there isn't enough evidence to know whether acetyl-L-carnitine helps improve fatigue associated with multiple sclerosis (MS) or not. More study is needed.
Acetyl-L-carnitine is a form of L-carnitine, an amino acid that is found in nearly all cells of the body. L-carnitine plays a critical role in the production of energy from long-chain fatty acids. In addition, it increases the activity of certain nerve cells in the central nervous system.
Fatigue is reported in up to 90% of people with multiple sclerosis. The cause of the fatigue isn't well understood. However, some types of MS-related fatigue may happen due to nighttime waking from bladder dysfunction, pain, depression or the effort it takes to perform daily duties.
As for treating fatigue with acetyl-L-carnitine, some studies have suggested that supplements could ease MS-related fatigue in people with low blood levels of L-carnitine.
A small study found that acetyl-L-carnitine works better than certain medications, such as amantadine, used to treat fatigue. But additional studies have had inconclusive results, showing a possible, but not statistically significant, benefit to acetyl-L-carnitine in MS-related fatigue.
Although acetyl-L-carnitine generally has few or mild side effects, it can interfere with blooding-thinning medications and other drugs. Therefore, have a discussion with your health care provider before taking acetyl-L-carnitine or any other dietary supplement.
Iris Marin Collazo, M.D.
Sept. 23, 2020
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See more Expert Answers
- Fatigue. National Multiple Sclerosis Society. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Fatigue. Accessed Sept. 2, 2020.
- Tejani AM, et al. Carnitine for fatigue in multiple sclerosis. Cochrane Database of Systematic Reviews. 2010; doi: 10.1002/14651858.CD007280.pub2. Accessed Sept. 2, 2020.
- Evans E, et al. Use of vitamins and dietary supplements by patients with multiple sclerosis. JAMA Neurology. 2018; doi:10.1001/jamaneurol.2018.0611.
- Yang TT, et al. Pharmacological treatments for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis. Journal of the Neurological Sciences. 2017; doi:10.1016/j.jns.2017.07.042.
- Acetyl-L-carnitine. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Sept. 2, 2020.
- Parks NE, et al. Dietary interventions for multiple sclerosis-related outcomes. Cochrane Database of Systematic Reviews. 2020; doi:10.1002/14651858.CD004192.pub4. Accessed Sept. 3, 2020.
- Tomassini V, et al. Comparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: Results of a pilot, randomized, double-blind, crossover trial. Journal of the Neurological Sciences. 2004; doi:10.1016/j.jns.2003.11.005.