Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Acetyl L-carnitine (ALC) has been investigated as a potential adjunctive therapy for Fibromyalgia Syndrome (FMS) due to its role in mitochondrial energy metabolism, neuroprotection, and modulation of neurotransmitters. Several small randomized controlled trials (RCTs) and open-label studies have suggested possible benefits of ALC supplementation in reducing pain, improving mood, and lessening fatigue among FMS patients. For example, a 2007 double-blind RCT (Cozzi et al., Clinical and Experimental Rheumatology) found that ALC led to modest improvements in pain and depressive symptoms versus placebo, with tolerable side effects. Another study (Rossini et al., 2007) reported similar findings, noting significant improvements in pain and general wellbeing. The proposed mechanisms include enhancement of mitochondrial function and modulation of glutamate and GABA neurotransmission, which may be relevant given the central sensitization hypothesized in FMS.

Despite these promising results, the body of evidence remains limited by small sample sizes, short study durations, and heterogeneity in outcome measures. Meta-analyses and systematic reviews have concluded that while there is preliminary evidence for ALC’s efficacy, larger and more rigorous trials are needed to establish its true benefit for FMS. Current clinical guidelines do not recommend ALC as a first-line treatment, but it may be considered as an adjunct in select patients. In summary, while ALC has some scientific support for use in FMS, the evidence is modest and further research is warranted.

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