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Acetyl-L-carnitine was tested to prevent nerve damage from chemotherapy and made it worse, with the extra damage still present two years later; guidelines advise against it. Plain L-carnitine for cancer fatigue has mixed results and guidelines do not recommend it either.
Memorial Sloan Kettering's About Herbs entry reports that in cancer settings acetyl-L-carnitine increased chemotherapy-induced peripheral neuropathy, an effect that persisted at two-year follow-up, and that current guidelines do not recommend it for preventing neuropathy. For L-carnitine, small oncology studies suggest improved nutritional status and quality of life in pancreatic cancer, fewer muscle spasms with vismodegib, and less chemotherapy-related fatigue alone or with coenzyme Q10, but a trial found no improvement in fatigue in people with invasive cancers and current guidelines do not recommend L-carnitine for cancer-related fatigue. Carnitine deficiency does occur with malnutrition, malabsorption and dialysis, and whether chemotherapy-induced carnitine insufficiency contributes to fatigue is unresolved. Side effects are usually mild (indigestion, a fishy body odour at high doses); MSK notes that L-carnitine may add to the anticoagulant effect of warfarin. Exercise and the approaches graded strong for fatigue are better supported.
Carnitine carries long-chain fatty acids into mitochondria for energy; the acetyl form crosses into the nervous system, where the expected protection did not appear in trials.
Query for this technology: (TITLE:"Carnitine and acetyl-L-carnitine" OR ABSTRACT:"Carnitine and acetyl-L-carnitine" OR TITLE:"L-carnitine" OR ABSTRACT:"L-carnitine" OR TITLE:"Acetyl-L-carnitine" OR ABSTRACT:"Acetyl-L-carnitine" OR TITLE:"ALCAR" OR ABSTRACT:"ALCAR") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Carnitine and acetyl-L-carnitine, not a curated reading list.
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