L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment: A randomized, double-blind, placebo-controlled trial

Jee Hyun An, Yoon Jung Kim, Kyeong Jin Kim, Sun Hwa Kim, Nam Hoon Kim, Hee Young Kim, Nan Hee Kim, Kyung Mook Choi, Sei-Hyun Baik, Dong Seop Choi, Sin Gon Kim

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Hypothyroid patients experience fatigue-related symptoms despite adequate thyroid hormone replacement. Thyroid hormone plays an essential role in carnitine-dependent fatty acid import and oxidation. We investigated the effects of L-carnitine supplementation on fatigue in patients with hypothyroidism. In total, 60 patients (age 50.0 ± 9.2 years, 3 males, 57 females) who still experienced fatigue (fatigue severity scale [FSS] score ≥ 36) were given L-carnitine (n = 30, 990 mg L-carnitine twice daily) or placebo (n = 30) for 12 weeks. After 12 weeks, although neither the FSS score nor the physical fatigue score (PFS) changed significantly, the mental fatigue score (MFS) was significantly decreased by treatment with L-carnitine compared with placebo (from 4.5 ± 1.9 to 3.9 ± 1.5 vs. from 4.2 ± 1.8 to 4.6 ± 1.6, respectively; P < 0.01). In the L-carnitine group, 75.0%, 53.6%, and 50.0% of patients showed improvement in the FSS score, PFS, and MFS, respectively, but only 20.0%, 24.0%, and 24.0%, respectively, did so in the placebo group (all P < 0.05). Both the PFS and MFS were significantly improved in patients younger than 50 years and those with free T3 ≥ 4.0 pg/mL by treatment with L-carnitine compared with placebo. Additionally, the MFS was significantly improved in patients taking thyroid hormone after thyroid cancer surgery. These results suggest that L-carnitine supplementation may be useful in alleviating fatigue symptoms in hypothyroid patients, especially in those younger than 50 years and those who have hypothyroidism after thyroidectomy for thyroid cancer (ClinicalTrials.gov: NCT01769157).

Original languageEnglish
Pages (from-to)885-895
Number of pages11
JournalEndocrine Journal
Volume63
Issue number10
DOIs
Publication statusPublished - 2016 Jan 1

Fingerprint

Carnitine
Hypothyroidism
Thyroxine
Fatigue
Placebos
Mental Fatigue
Thyroid Hormones
Therapeutics
Thyroid Neoplasms
Thyroidectomy
Fatty Acids

Keywords

  • Fatigue
  • Fatigue severity scale
  • Hypothyroidism
  • L-carnitine
  • Wessely and powell score

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment : A randomized, double-blind, placebo-controlled trial. / An, Jee Hyun; Kim, Yoon Jung; Kim, Kyeong Jin; Kim, Sun Hwa; Kim, Nam Hoon; Kim, Hee Young; Kim, Nan Hee; Choi, Kyung Mook; Baik, Sei-Hyun; Choi, Dong Seop; Kim, Sin Gon.

In: Endocrine Journal, Vol. 63, No. 10, 01.01.2016, p. 885-895.

Research output: Contribution to journalArticle

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abstract = "Hypothyroid patients experience fatigue-related symptoms despite adequate thyroid hormone replacement. Thyroid hormone plays an essential role in carnitine-dependent fatty acid import and oxidation. We investigated the effects of L-carnitine supplementation on fatigue in patients with hypothyroidism. In total, 60 patients (age 50.0 ± 9.2 years, 3 males, 57 females) who still experienced fatigue (fatigue severity scale [FSS] score ≥ 36) were given L-carnitine (n = 30, 990 mg L-carnitine twice daily) or placebo (n = 30) for 12 weeks. After 12 weeks, although neither the FSS score nor the physical fatigue score (PFS) changed significantly, the mental fatigue score (MFS) was significantly decreased by treatment with L-carnitine compared with placebo (from 4.5 ± 1.9 to 3.9 ± 1.5 vs. from 4.2 ± 1.8 to 4.6 ± 1.6, respectively; P < 0.01). In the L-carnitine group, 75.0{\%}, 53.6{\%}, and 50.0{\%} of patients showed improvement in the FSS score, PFS, and MFS, respectively, but only 20.0{\%}, 24.0{\%}, and 24.0{\%}, respectively, did so in the placebo group (all P < 0.05). Both the PFS and MFS were significantly improved in patients younger than 50 years and those with free T3 ≥ 4.0 pg/mL by treatment with L-carnitine compared with placebo. Additionally, the MFS was significantly improved in patients taking thyroid hormone after thyroid cancer surgery. These results suggest that L-carnitine supplementation may be useful in alleviating fatigue symptoms in hypothyroid patients, especially in those younger than 50 years and those who have hypothyroidism after thyroidectomy for thyroid cancer (ClinicalTrials.gov: NCT01769157).",
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