L-Glutamine

BCCT plans to write a summary on L-glutamine. While our summary is in development, you can visit About Herbs: Glutamine

Our bodies normally synthesize glutamine. Glutamine can also be obtained from foods or supplements. Important food sources:

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During a critical illness like cancer, not enough glutamine may be synthesized, leading to problems such as fatigue and muscle wasting.

Clinical Practice Guidelines

The Society for Integrative Oncology 2017 clinical practice guidelines for breast cancer review the evidence for using L-glutamine with these recommendations:1

  • Insufficient evidence for relieving radiation therapy-induced toxicity outcomes
  • Should not be recommended for improving nausea and vomiting during chemotherapy (grade D: moderate or high certainty that the modality has no net benefit)

Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

L-glutamine is proposed for relief of several side effects and symptoms, such as cachexia (muscle and tissue wasting).

Cautions

The About Herbs summary of L-glutamine states that studies in people with cancer show oral glutamine to be well-tolerated. However people have reported adverse reactions with specific oral preparations. The summary also describes herb-drug interactions.

Also of concern are recent preliminary research reports that cancer cells may depend on glutamine for growth and maintenance and that glutamine may help cancer cells survive acidic stress. Ralph Moss, PhD, in his Moss Report cautions against taking L-glutamine while “fighting cancer." He explains that most cells get energy from the fermentation of glucose, but a few cancers use glutamine instead of glucose for fuel.2

BCCT advisor Lise Alschuler, ND, FABNO, has stated that this caution is most relevant when considering long-term, high-dose L-glutamine (above 1g or 3g depending on which reference you use). To err on the side of caution, she limits use to address specific symptoms for as short a duration as possible. For example, to address peripheral neuropathy related to taxanes, she uses L-glutamine only on the day of and for three days after each chemotherapy treatment.  See the About Herbs summary for further information: Glutamine.

Raymond Chang, MD, cautions taking glutamine supplements without direction from your physician if you have liver or kidney dysfunction.3

BCCT recommends you consult with your oncology physician before taking L-glutamine and use under the supervision of a clinician knowledgeable of its use in cancer.

Dosing

BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated.

Dosage recommendations are available from these sources:

Integrative Plans, Protocols and Medical Systems

For more information about plans and protocols, see our Integrative Plans and Protocols page.
  • Plans, protocols and programs
    • Abrams & Weil integrative medicine approaches: chemotherapy-induced peripheral neuropathy4
    • Alschuler & Gazella complementary approaches5
      • Breast cancer
      • Colorectal cancer
      • Esophageal cancer
      • Soft tissue sarcomas
      • Healthy digestion
      • Support during radiation therapy
    • Block program6
      • Treatment support diet for diarrhea and mucositis
      • Taxol-induced peripheral neuropathy
      • Taxol-related joint and muscle pain
      • Radiation coupler to reduce mucositis and enteritis
      • Mucositis from bone marrow transplant
    • McKinney protocols7
      • Treatment induced diarrhea
      • Peripheral neuropathy and muscle damage from platins and taxanes
      • Stomatitis (inflammation of the mouth)
      • Cachexia (muscle wasting)

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