L-Carnitine in the treatment of fatigue in adult celiac disease patients: a pilot study

Dig Liver Dis. 2007 Oct;39(10):922-8. doi: 10.1016/j.dld.2007.06.013. Epub 2007 Aug 10.


Background: Fatigue is common in celiac disease. L-Carnitine blood levels are low in untreated celiac disease. L-Carnitine therapy was shown to improve muscular fatigue in several diseases.

Aim: To evaluate the effect of L-carnitine treatment in fatigue in adult celiac patients.

Methods: Randomised double-blind versus placebo parallel study. Thirty celiac disease patients received 2 g daily, 180 days (L-carnitine group) and 30 were assigned to the placebo group (P group). The patients underwent clinical investigation and questionnaires (Scott-Huskisson Visual Analogue Scale for Asthenia, Verbal Scale for Asthenia, Zung Depression Scale, SF-36 Health Status Survey, EuroQoL). OCTN2 levels, the specific carnitine transporter, were detected in intestinal tissue.

Results: Fatigue measured by Scott-Huskisson Visual Analogue Scale for Asthenia was significantly reduced in the L-carnitine group compared with the placebo group (p=0.0021). OCTN2 was decreased in celiac patients when compared to normal subjects (-134.67% in jejunum), and increased after diet in both celiac disease treatments. The other scales used did not show any significant difference between the two celiac disease treatment groups.

Conclusion: L-Carnitine therapy is safe and effective in ameliorating fatigue in celiac disease. Since L-carnitine is involved in muscle energy production its decreased absorption due to OCTN2 reduction might explain muscular symptoms in celiac disease patients. The diet-induced OCTN2 increase, improving carnitine absorption, might explain the L-carnitine treatment efficacy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Biomarkers / metabolism
  • Biopsy
  • Carnitine / administration & dosage
  • Carnitine / pharmacokinetics
  • Carnitine / therapeutic use*
  • Celiac Disease / complications*
  • Celiac Disease / diagnosis
  • Celiac Disease / drug therapy
  • Chromatography, High Pressure Liquid
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Electrophoresis, Polyacrylamide Gel
  • Fatigue / blood
  • Fatigue / drug therapy*
  • Fatigue / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Jejunum / metabolism
  • Jejunum / pathology
  • Male
  • Organic Cation Transport Proteins / metabolism
  • Pilot Projects
  • Quality of Life
  • Solute Carrier Family 22 Member 5
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vitamin B Complex / administration & dosage
  • Vitamin B Complex / pharmacokinetics
  • Vitamin B Complex / therapeutic use*


  • Biomarkers
  • Organic Cation Transport Proteins
  • SLC22A5 protein, human
  • Solute Carrier Family 22 Member 5
  • Vitamin B Complex
  • Carnitine