Acetyl Carnitine as Cancer Adjunct to Reduce Peripheral Neuropathy

Some of the more effective chemotherapeutic drugs produce the negative effect of peripheral neuropathy–damage to the nerves of the arms and legs with symptoms that include tingling, numbness, and burning pain in the hands and feet, as well as gradual weakness of the muscles in the arms and legs.  This often limits the usage of such drugs.  It is known that painful peripheral neuropathy is produced by both the taxane agent, Paclitaxel, and the platinum-complex agent, Oxaliplatin, occurs through a common mechanism-a toxic effect on the mitochondria in primary afferent sensory neurons (nerve cells).  A new study demonstrates that another chemotherapeutic agent from a different class, Bortezomib, a proteasome-inhibitor, produces peripheral neuropathy through the same mechanism–damage to the mitochondria in the peripheral nerve cells.  Supplementing with acetyl carnitine was shown to prevent peripheral neuropathy with Bortezomib by supporting the mitchondria, much as it does with paclitaxel and oxaliplatin.  It is likely that other nutrients that support mitochondrial function, such as lipoic acid, creatine, D-ribose, coenzyme Q10, magnesium, and B vitamins may also be useful adjuncts while taking chemotherapy.

How much acetyl carnitine should be taken?  Each of us are unique and our physiologies, our size, our overall level of health, and our individual response needs to be considered.  If you are suffering with neuropathy related to undergoing chemo, then the type of chemo and the dosage must be taken into account as well as the severity of your symptoms.  I recommend a combination of 500-1000 mg acetyl carnitine plus 100-250 mg lipoic acid taken 2-3 times per day between meals as well as a good B-complex (or a combination of B1, B6, and methyl B12) and a quality fish oil taken twice per day with food.  It may also be helpful to add some GLA in the form of evening primrose oil or borage seed oil.  Some patients have also gotten some relief with benfotiamine, a synthetic derivative of vitamin B1 that has been licensed in Germany since 1993 for the treatment of peripheral neuropathy.  If you are suffering with neuropathy from diabetes or from autoimmune diseases (such as rheumatoid arthritis, lupus, MS, or sarcoidosis),  or infectious disease such HIV, or genetic diseases, such as Charcot-Marie-Tooth disease, the recommendations will likely change.

 

Zheng H, Xiao WH, Bennett GJ. Mitotoxicity and bortezomib-induced chronic painful peripheral neuropathy. Exp Neurol. 2012 Dec;238(2):225-34.

 

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