Gramignano, G., Lusso, M. R., Madeddu, C., Massa, E., Serpe, R., Deiana, L., . . . Mantovani, G. (2006). Efficacy of l-carnitine administration on fatigue, nutritional status, oxidative stress, and related quality of life in 12 advanced cancer patients undergoing anticancer therapy. Nutrition, 22, 136–145.

Carnitine is a cofactor required for cell energy production that serves as the primary fuel source for heart and skeletal muscles. Cancer-related anorexia/cachexia syndrome (CACS) and oxidative stress (OS) are two prominent features in patients with advanced cancer; therefore, L-carnitine supplementation was tested in patients with advanced cancer. Based on the current knowledge of carnitine use, patients took three doses (2 g) of L-carnitine orally each day for four weeks. Patient outcomes were evaluated at baseline (T0), week two (T1), and week four (T2).

• Twelve patients with locally advanced or metastatic disease were included.
• Mean age was 60 years (range 42–73).
• The majority of patients were women (n = 10) with mixed tumor sites (most common being gynecological cancer), and most were receiving concomitant chemotherapy (n = 10). 
• Patients were excluded if they had an Eastern Cooperative Oncology Group (ECOG) performance status of greater than 2, had insulin-dependent diabetes mellitus, or were pregnant.

Patients were undergoing the active treatment phase of care.

The study was an open-label, nonrandomized trial. 

Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF)

The L-carnitine intervention resulted in improved fatigue outcomes. The observed decline in MFSI-SF fatigue scores was statistically significance at both T1 (p < 0.05) and T2 (p < 0.001) in comparison to the baseline scores. Mean MFSI-SF scores at T0, T1, and T2 were 25.40 (standard deviation [SD] = 13.91), 16.93 (SD = 11.92), and 12.05 (SD = 12.56), respectively. Evaluation of subscales showed a statistically significant difference from T0 to T1 for the General subscale (p < 0.05) and the Physical subscale (p < 0.05).

• The study had a small sample size. 
• The study lacked a neutral comparison group.