Carnitine Deficiency Due to Chemo

Carnitine is a compound that aids the body in fatty acid metabolism (turning fat into energy), and it is can be depleted by the administration of ifosfamide and cisplatin, two relatively common drugs used in chemotherapy.

Chemo's Role in Deficiency

• The administration of the drugs ifosfamide and cisplatin can cause a carnatine deficiency in cancer patients undergoing chemotherapy. Ifosfamide causes carnatine esters to be created and excreted in the urine, lowering levels of carnitine in the body. Cisplatin also increases carnitine secretion through the urine.

Symptoms

• Symptoms of carnitine deficiency include cardiomyopathy (weakening of the heart, impairing its ability to effectively pump blood), weakening of skeletal muscles thanks to impaired muscle metabolism, and hypoglycemia (low blood sugar).

Diagnosis

• Diagnosis of carnitine deficiency is usually done via a blood test and urine test, looking for depleted carnitine levels in the blood or increased carnitine levels in the urine. If ifosfamide and cisplatin are being administered during chemotherapy, blood and urine tests are often done, but deficiency can generally be assumed and treated without testing.

Treatment

• Treatment for carnitine deficiency is uncomplicated, and requires simple administration of dietary carnitine through oral or intravenous means. Because there are no toxic effects (aside from mild discomfort and nausea) of carnitine, massive doses can be used to ensure absorption.

Prognosis

• If the patient properly takes the required carnitine supplementation, and the deficiency is caused by chemotherapy drugs, prognosis is extremely good, and carnitine supplementation can be continued with no ill effects for the duration of the chemotherapy.