Evaluating the effect of L-carnitine supplement on fatigue severity in patients with Multiple Sclerosis

Abstract

Introduction Fatigue is a highly prevalent symptom affecting almost 90% of multiple sclerosis (MS) patients and is considered as one of the most debilitating aspects of the disease, leading to a substantial decline in their quality of life. Since a variety of factors can cause this symptom, managing fatigue is a challenging task. While there are some medications available to alleviate MS-related fatigue, they are limited in efficacy and may come with limiting side effects. Futhermore, data from randomized studies do not support the efficacy of these agents in treating fatigue in MS. Consequently, it is not possible to consider a safe drug with few side effects, accessible and without a prescription to manage fatigue in MS patients, and newer strategies should be studied in this field. Purpose: This study aims to evaluate the efficacy of L-carnitine supplement in reducing MS-related fatigue compared to a placebo.Methods: The study adopted a randomized, placebo-controlled, and double-blinded clinical trial design, enrolling 112 patients. Eligible participants were Persian RRMS patients experiencing fatigue with a disability level of ≤3.5 on the Kurtzke Expanded Disability Status Scale (EDSS) and aged between 18 and 60 years. The patients were randomly assigned to receive either L-carnitine 1000 mg twice a day (intervention group) or a placebo (control group) for a duration of two months. Each group consisted of 56 patients. The fatigue severity scale (FSS) and modified fatigue impact scale (MFIS) were utilized to assess the treatment efficacy.Results: The mean age of patients was 39.4 ± 8.8 years and 72.3% of enrolled patients were female. Statistical analysis demonstrated that the mean changes in FSS scores for the intervention and control groups were -1.24 and -0.2, respectively (P-value<0.001). Additionally, the mean changes in MFIS scores for the intervention and control groups were -15.18 and -3.06 respectively (P-value<0.001).Conclusion The findings of this study suggest that L-carnitine is significantly more effective than a placebo in reducing fatigue among patients with MS.