Glutamine is the most abundant free amino acid in the body. It is produced primarily in skeletal muscle and then released into the circulation. Tissues that require glutamine such as the immune system, gastrointestinal tract, kidneys, and liver obtain glutamine as needed from the blood. Glutamine is the supplement that has been most often studied to prevent and treat oral mucositis resulting from either chemotherapy or radiation.
Glutamine appears to decrease the incidence, severity, and duration of mouth pain in some patients undergoing cancer chemotherapy or bone marrow transplant.
In addition, glutamine showed benefit for chemotherapy-related intestinal toxicity in some studies including reduction of chemotherapy-induced diarrhea, but so far research findings have been inconsistent.
In addition, there is conflicting evidence regarding the potential benefits of glutamine for preventing chemotherapy-induced reduction of lymphocytes.
Neuropathy can also be affected by glutamine. In a non-randomized controlled clinical trial, patients receiving high dose paclitaxel were given either usual care or glutamine at a dose of 10 grams three times a day for four days starting 24 hours after chemotherapy. The glutamine-treated group showed a statistically significant decrease in the severity of sensory neuropathy both for dysesthesia and numbness as well as better motor function with a lower incidence and severity of motor weakness and less disturbance in gait, resulting in less interference with the activities of daily living for the glutamine group.
None of the glutamine studies reviewed demonstrated any toxicity, and the treatment was generally well tolerated. In one study where it was examined, glutamine did not increase the relapse rate, progression of malignancy, or incidence of graft-vs-host disease.
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