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  Jerry W. Swanson, M.D.

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  Biography of

  Jerry W. Swanson, M.D.

  Jerry W. Swanson, M.D.

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  Dr. Jerry Swanson is a board-certified neurologist at Mayo Clinic in Rochester, Minn. He is also board certified in headache medicine and is a professor of neurology at College of Medicine, Mayo Clinic. He has a special interest in medical education.

  Dr. Swanson, a Lacon, Ill., native, was appointed to the Mayo Clinic staff in 1982 and works in the Department of Neurology with more than 90 other physicians. He formerly chaired the department's Division of Headache and continues to work with headache subspecialists around the world. He has published and lectured widely on headache disorders. He also serves as assistant dean for assessment at Mayo Medical School.

  "In a manner similar to the printing press, Internet technology enables the unprecedented ability to communicate with the global community about health information," Dr. Swanson says. "There is no doubt that the knowledgeable individual contributes greatly to his or her own health care, and now we can share information much more widely.

  "There is much information already available about health care on the Internet. Unfortunately, much of it is not founded on sound principles. It is exciting to be a part of the web team and contribute to the creation of a reliable and timely health resource."

  Dr. Swanson is the neurology editor for "Mayo Clinic Family Health Book" and has reviewed articles for "Mayo Clinic Health Letter" and "Mayo Clinic Women's HealthSource." He is also editor-in-chief of the "Mayo Clinic on Headache" book, published in 2004. In 2008 the magazine Women's Health named him one of America's Top Doctors for Women. In 2011 he received the Mayo Medical School Dean's Recognition Award for his contributions to undergraduate medical education.

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Question

Acetyl-L-carnitine: Can it relieve MS fatigue?

I've read that the dietary supplement acetyl-L-carnitine may reduce fatigue in multiple sclerosis. Is this true?

Answer

from Jerry W. Swanson, M.D.

Some research suggests that acetyl-L-carnitine can improve fatigue associated with multiple sclerosis (MS), although more study is needed.

Acetyl-L-carnitine is a form of L-carnitine, an amino acid that is found in nearly all cells of the body. L-carnitine plays a critical role in the production of energy from long-chain fatty acids. In addition, it increases the activity of certain nerve cells in the central nervous system.

Fatigue is a common symptom in people with multiple sclerosis. The cause isn't well understood. A study published in 2006 evaluated the benefit of supplementation with L-carnitine in people with MS-related fatigue who had low blood levels of L-carnitine. Study participants were given 3 to 6 grams of oral L-carnitine daily. Researchers reported a decrease in fatigue intensity in 65 percent of participants treated with immunosuppressive drugs, especially in those treated with cyclophosphamide and interferon beta. Another study published in 2004 showed that acetyl-L-carnitine seemed to improve fatigue in people with MS better than amantadine, a drug commonly used to treat MS-related fatigue.

However, problems with the design of these studies make it unclear whether acetyl-L-carnitine is truly effective at reducing MS-related fatigue. A recent systematic review published in 2012 concluded that there is still insufficient evidence that carnitine offers a therapeutic advantage over placebo or other medications. An ongoing larger scale randomized, placebo-controlled clinical trial expected to be completed in 2013 may answer some of these questions.

Although acetyl-L-carnitine generally has few or mild side effects, it can interfere with anticoagulants and other medications. So talk to your doctor before starting acetyl-L-carnitine or any dietary supplement.

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