Carnitine Deficiency and Improvement of Muscle Cramp by Administration of Carnitine in Patients with Liver Cirrhosis

Naoki Hotta

doi:10.4236/ojgas.2014.45036

Abstract

Aim: We measured carnitine levels in patients with carnitine including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 27 patients with liver cirrhosis who were receiving treatment in our hospital, and administered L-carnitine (600 mg - 1800 mg) to patients having muscle cramps for approximately one month and examined the presence/absence of the symptom. We measured carnitine concentration before and after dialysis, before dialysis after the administration to eight dialysis patients, before and after the administration to 19 nondialytic patients. Results: The total carnitine levels before the dialysis of dialysis patients were an average of 42.2 μmol/L and fell to 17.7 μmol/L after more dialysis, but it was increased to 155 μmol/L after the administration of L-carnitine. In the nondialytic patients, the total carnitine levels were significantly increased from 71.7 μmol/L to 101.7 μmol/L after the administration of L-carnitine (P = 0.038). For symptomatic patients, significant improvement of muscle clamps was observed in the L-carnitine administrated group when compared with the non-administrated group (P = 0.0002). Conclusions: Total carnitine levels were low even before dialysis in the dialysis patients with liver cirrhosis in particular and they further decreased after the dialysis. Administration of L-carnitine increased the total carnitine levels and improved the symptom. Based on these results, we conclude that L-carnitine is useful for carnitine deficiency in patients with liver cirrhosis.

Highlights

In recent years, we occasionally come across some reports that carnitine is useful for improving blood ammoniaHow to cite this paper: Hotta, N. (2014) Carnitine Deficiency and Improvement of Muscle Cramp by Administration of Carnitine in Patients with Liver Cirrhosis
In the non-dialysis patients, no significant differences was observed in patient backgrounds between the LC group of 12 patients and non-administration group of 7 patients
Takayanagi reported that carnitine was an amino acid derivative with low molecular weight and played an important role in energy metabolism [7]

Summary

Introduction

We occasionally come across some reports that carnitine is useful for improving blood ammoniaHow to cite this paper: Hotta, N. (2014) Carnitine Deficiency and Improvement of Muscle Cramp by Administration of Carnitine in Patients with Liver Cirrhosis. We occasionally come across some reports that carnitine is useful for improving blood ammonia. (2014) Carnitine Deficiency and Improvement of Muscle Cramp by Administration of Carnitine in Patients with Liver Cirrhosis. N. Hotta and cognitive function in hepatic cirrhosis patients with latent hepatic encephalopathy [1]-[3]. Levocarnitine chloride (L-Cartin® tablets 100 mg, 300 mg: Otsuka Pharmaceutical Co., Ltd., hereinafter referred to as LC) has become available in Japan as a pharmaceutical agent for patients suspected of having carnitine deficiency. We measured serum carnitine concentrations in hepatic cirrhosis patients including dialysis patients and examined whether their cramps improved or not. Muscle spasms and hypotension during dialysis, atrophy of skeletal muscles and decrease in exercise capacity, anemia, and reduced cardiac function associated with decreased carnitine levels in dialysis patients have been reported [4]-[6]. Whereas a majority of the reports on the utility of carnitine have used supplements, we used LC for this investigation

Objectives

Methods

Results

Conclusion