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Carnitine study for neuropathy
Aug 6, 2004

Hi dr. Henry.

Did you read this study? Have you ever used this?

"Acetyl-l-carnitine (ALCAR) stimulated nerve regeneration in HIV-infected people with peripheral neuropathy and relieved neuropathic pain in most of them.

Hypothesizing that restoring depleted ALCAR levels would promote nerve growth and ease the burning pain of neuropathy, London clinicians gave 1500 mg of ALCAR twice daily to 21 people with established antiretroviral-induced neuropathy for up to 33 months. Skin biopsies from the leg before and at 6- to 12-month intervals after beginning ALCAR therapy documented significant growth of small sensory fibers in the epidermis, dermis, and sweat glands. Compared with biopsies in untreated volunteers without neuropathy, the nerve supply reached 92%, 80%, and 69% in epidermis, dermis, and sweat glands after 6 months in treated individuals. Nerve proliferation continued for 24 months. Neuropathic grade improved in 76% of the treated people and remained unchanged in 19%.

The authors propose that ALCAR may be a pathogenesis-based treatment for distal peripheral neuropathy.

Source: Andrew M. Hart, Andrew D.H. Wilson, Cristina Montovani, Collette Smith, Margaret Johnson, Giorgio Terenghi, Mike Youle. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS 2004;18:1549-1560.

Response from Dr. Henry

Yes I have read that paper with interest. The ACTG is conducting a study using ALCAR starting at 1000 mg and then dosing upwards to evaluate its effect on the symptoms of neuropathy as well as the nerve fiber density evaluations used by the group in Londoon-very interesting and hopeful. The ACTG is also soon opening a study using prosaptide O for treatment of neuropathy and a study using a high dose of topical potent capsaicin is open and enrolling patients so there is hope on the important problem of neuropathy. KH

Neuropathy/Triglyceride regime dilemma
Afraid of KS but lack medicare

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