Evidence supporting the use of: L-carnitine
For the health condition: Peripheral Neuropathy

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Synopsis

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

L-carnitine, and its acetylated form acetyl-L-carnitine (ALC), have been investigated as potential treatments for peripheral neuropathy, particularly neuropathies induced by diabetes or chemotherapy. The scientific rationale stems from carnitine’s role in mitochondrial energy metabolism and its neuroprotective properties. Several randomized controlled trials (RCTs) and meta-analyses have evaluated the efficacy of L-carnitine or ALC in this context.

A 2019 meta-analysis published in Diabetes Research and Clinical Practice evaluated acetyl-L-carnitine for diabetic peripheral neuropathy and found a statistically significant reduction in pain and improvement in nerve conduction velocity compared to placebo. Other RCTs have shown that ALC can improve symptoms such as numbness, pain, and tingling, with relatively few side effects. For example, a 2002 study in Diabetes Care demonstrated improvements in nerve fiber regeneration and pain reduction in patients with diabetic neuropathy.

For chemotherapy-induced peripheral neuropathy (CIPN), results are more mixed. Some trials have suggested benefit, but others, such as a 2013 study in JAMA, did not show significant improvement, and even reported possible worsening of symptoms with ALC in certain populations.

Overall, while there is scientific evidence supporting the use of L-carnitine (particularly ALC) for certain forms of peripheral neuropathy, the magnitude of benefit appears moderate, and results vary depending on the cause of neuropathy and study design. Thus, the evidence is rated 3/5, indicating moderate scientific support.

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