Effect of L-carnitine on the physical fitness of thalassemic patients.

http://www.ncbi.nlm.nih.gov/pubmed/17031691

L carnitine for patients with thalassemia
Effect of L-carnitine on the physical fitness of thalassemic patients.
Ann Hematol. 2007 January. El-Beshlawy A, El Accaoui R, Abd El-Sattar M, Gamal El-Deen MH, Youssry I, Shaheen N, Hamdy M, El-Ghamrawy M, Taher A. Department of Pediatrics, New Children Hospital, Cairo University, Cairo, Egypt.
Poor physical fitness is a common problem among thalassemic patients. L-Carnitine plays an essential role in fatty acid beta-oxidation, a process especially important in the organs that preferentially use fatty acid as a source of energy such as the myocardium and the skeletal muscles. The main objective of this study is to assess the effect of the administration of oral L-carnitine on exercise tolerance and physical fitness in patients with thalassemia major. Thirty patients followed up at the New Cairo University Children Hospital were included in this study. Clinical, laboratory, and cardiopulmonary exercise testing were performed before and after 6 months of oral L-carnitine therapy (50 mg per kg per day). The oxygen consumption, cardiac output, and oxygen pulse at maximal exercise significantly increased after L-carnitine therapy. However, there was no significant change in minute ventilation and ventilatory equivalent of carbon dioxide. There was also significant increase in the blood transfusion intervals after L-carnitine administration. However, there was no significant change in hemoglobin concentration. L-Carnitine seems to be a safe and effective adjunctive therapeutic approach in thalassemic patients. It improves their cardiac performance and physical fitness. The younger the patients are, the higher is the degree of improvement in their exercise parameters.

Thals need to understand that it isn't just their Hb level that determines how well they feel and how well they do. The health of the blood vessels is extremely important and this will not show up in Hb levels. L-carnitine helps to prevent the loss of flexibility in blood vessels, which leads to PHT, and tremendous stress on the heart. I highly recommend L-carnitine as a supplement for thals.

Thank you for this information Andy,  I will be sure to get a prescription for my son.  I want to start him on L-carnitine as soon as possible. 

Sharmin

Even after showing the numerous benifits of L- Carnitine my doc refuses to prescribe it  . Is it safe enough to be given without prescription?
maha

Maha, i guess it is safe, as i told you it could be even taken during pregnancy, but what is his point of view???

manal

One more thing i want to point to is that it is given 5 days in a week and you have two days off. Actually i don't know why,i will ask the hematologist and let you know

manal

   I don't know about 5 days/a week, Manal. I take carnitine every day, the drinkable solution which I mix with a little water.

Lena.

Lena, i will be seeing the hematologist tomorrow and will ask her the reason for that, but ususally she makes sure that my son takes it 5days/week.

When we started it at the begining, it was everyday for one month, then the next month was 6 days per week and finally 5 days per week

until then stay well

manal

Manal,

I will definitely need your guidance when I get Lcarnitine for my son next month. 

Sharmin

Sharmin, anything you need to ask about it let me know cause i will see the hema tomorrow, just anything let me know. By the way she was th head of the doctors who conducted all the studies regarding L-carnitine.

manal

By the way she was th head of the doctors who conducted all the studies regarding L-carnitine.

That is a great source.  My questions have to do mostly with dosing, which I will ask you when I have purchased the supplement and begin giving it to him.  From your earlier post I understand that I should be giving it to him every day for the first little way and then taper down to 6 and finally 5 days a week. 

Thanks again Manal, I am so glad that I learned about this supplement from you.  The more I learn about it the more I cannot wait to begin giving it to my son. 

Sharmin, Lena and everyone

After asking doctor El Beshalawy about the reason for this dosing, she told me because they found in their studies that L-carnitine when taken daily causes depression of the bone marrow leading to aplasia and taking two days off avoid this to happen.

When i told her that some people take it daily, Dr. El Beshlawy said that they have to moniter their Hb and other blood products.

She said that another doctor in the States ( can not recall the name ) had the same result with his study of L-carnitine.

Andy, this year she will release her study about the positive effect of L-carnitine over PHT

All the doctor's studies are based on 50mg/kg but she told me that it can be taken up to 100mg/kg


I asked her if hydrea could lead to aplasia as found with L-carnintine, she said no because this is compansated by the induction of fetal Hb

By the way l-carnitinne release some fetal Hb too

manal

Dear Manal,

is there any place I can find this study by dr. El Beshlawi? I told that to my hemo and she asked if I could pass her this study because she had read a study by dr.El Beshlawi that praised the advantages of L-Carnitine. According to my hemo, who has also studied the subject, carnitine lessens the intervals between transfusions as well as prolongs the survival of red cells.
She was surprised by what I told her about only 5 days a week and asked for this study, if there is one.

Lena.

Lena, this does not at all contradicts with the benefits of L-carnitine and still Dr. El Beshhlawy praises it and insists on its importance. It is the way it is taken only which does not diminish anything of its benefits. I just want to make sure this note is clear

When i told her about you taking it everyday, she told me exactly that this is okay as long as you keep monitering all blood products

Next time when i see her i will ask her about any documented study about this finding

take care
manal

Do not worry Manal, everything is clear to me. I did not get it wrong.I know the importance of Carnitine. I only wanted to clear this up with my hemo and she responded immediately and wants to take it further.So please, if this is not much trouble with you, ask her for anything I can pass on to my hemo.

Shokran.

Hi Manal
L-Carnitine is not available here . One of the stores had something called acetyl L-carnitine. How same or different is it from L-Carnitine. Could you tell me the name of the brand you use. It should be available in the UAE, and I could get it from there.
thankyou
maha