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Because carnitine is a necessary substrate for energy metabolism, a deficiency in this amino acid derivative is hypothesized to contribute to fatigue in chronic illness. Cancer patients can be deficient in carnitine because of low oral intake as well as high renal loss associated with chemotherapy. Investigators in New York conducted a phase I/II study to evaluate l-carnitine supplementation in adults with advanced cancer and moderate-to-severe fatigue.
To establish the safety and efficacy of maximum-tolerated doses of l-carnitine supplements, carnitine-deficient patients (free carnitine in plasma, <35 μM/L for men and <25 μM/L for women) with Karnofsky Performance Status ≥50 were enrolled. Exclusion criteria included hemoglobin levels <9 g/…