A review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D

Nutr Res Rev. 2018 Dec;31(2):281-290. doi: 10.1017/S0954422418000124. Epub 2018 Jul 9.


Sepsis is defined as the dysregulated host response to an infection resulting in life-threatening organ dysfunction. The metabolic demand from inefficiencies in anaerobic metabolism, mitochondrial and cellular dysfunction, increased cellular turnover, and free-radical damage result in the increased focus of micronutrients in sepsis as they play a pivotal role in these processes. In the present review, we will evaluate the potential role of micronutrients in sepsis, specifically, thiamine, l-carnitine, vitamin C, Se and vitamin D. Each micronutrient will be reviewed in a similar fashion, discussing its major role in normal physiology, suspected role in sepsis, use as a biomarker, discussion of the major basic science and human studies, and conclusion statement. Based on the current available data, we conclude that thiamine may be considered in all septic patients at risk for thiamine deficiency and l-carnitine and vitamin C to those in septic shock. Clinical trials are currently underway which may provide greater insight into the role of micronutrients in sepsis and validate standard utilisation.

Keywords: l-Carnitine; ICU intensive care unit; LPS lipopolysaccharide; Micronutrients; Selenium; Sepsis; Thiamine; Vitamin C; Vitamin D.

Publication types

  • Review

MeSH terms

  • Ascorbic Acid / therapeutic use*
  • Carnitine / therapeutic use*
  • Deficiency Diseases / etiology
  • Deficiency Diseases / prevention & control*
  • Dietary Supplements
  • Humans
  • Micronutrients / therapeutic use
  • Nutritional Status
  • Selenium / therapeutic use*
  • Sepsis / complications
  • Sepsis / drug therapy*
  • Shock, Septic / drug therapy
  • Thiamine / therapeutic use*
  • Thiamine Deficiency / etiology
  • Thiamine Deficiency / prevention & control
  • Vitamin D / therapeutic use*


  • Micronutrients
  • Vitamin D
  • Selenium
  • Ascorbic Acid
  • Carnitine
  • Thiamine