Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Glutamine is a non-essential amino acid that becomes conditionally essential during times of metabolic stress, such as chemotherapy. Its use to reduce chemotherapy-induced side effects—particularly mucositis (inflammation of the mucous membranes) and neuropathy—has been investigated in multiple clinical studies. The rationale is primarily based on glutamine's role in supporting rapidly dividing cells, immune function, and the maintenance of gut barrier integrity, which can be compromised during chemotherapy.

Some randomized, controlled trials and meta-analyses suggest that oral glutamine supplementation can reduce the severity and duration of oral mucositis in patients receiving chemotherapy and/or radiation for cancer, especially in hematological malignancies and head and neck cancers. There is also emerging, though less robust, evidence for its benefit in reducing chemotherapy-induced peripheral neuropathy, especially with agents like paclitaxel and oxaliplatin. However, the magnitude of the effect varies between studies, and not all trials have shown significant benefits.

Major oncology guidelines remain cautious, generally neither endorsing nor outright discouraging glutamine use, due to some concern about potential stimulation of tumor growth (not supported by current data) and inconsistent study results. Nonetheless, glutamine is sometimes recommended or used off-label to manage mucositis and neuropathy, and it is included in some clinical protocols.

In summary, there is moderate scientific evidence supporting the use of glutamine as an adjunct to reduce certain side effects of chemotherapy, though more high-quality trials are needed to clarify its efficacy and safety.

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