Glutamine is taken by mouth for sickle cell disease, to improve nutrition and help people recover from surgery, injuries, burns, bone marrow transplant, complications of HIV/AIDS, radiation, and cancerchemotherapy, and for many other uses. Glutamine is given intravenously (by IV) for improving recovery after surgery and other conditions.
Glutamine is commercially available as capsules or in packets as a powder form. There are two prescription glutamine products approved by the U.S. Food and Drug Administration (FDA): Endari (Emmaus Medical, Inc) and NutreStore (Emmaus Medical, Inc). Glutamine for commercial use is made by a fermentation process using bacteria that produce glutamine.
How does it work ?
After surgery or traumatic injury, nitrogen is necessary to repair the wounds and keep the vital organs functioning. About one third of this nitrogen comes from glutamine.
If the body uses more glutamine than the muscles can make (i.e., during times of stress), muscle wasting can occur. This can occur in people with HIV/AIDS. Taking glutamine supplements might keep the glutamine stores up.
Some types of chemotherapy can reduce the levels of glutamine in the body. Glutamine treatment is thought to help prevent chemotherapy-related damage by maintaining the life of the affected tissues.
Uses & Effectiveness ?
Likely Effective for
- Sickle cell disease. Glutamine is an FDA-approved prescription drug for sickle cell disease. Taking it by mouth twice daily reduces sudden complications of sickle cell disease. Prescription glutamine might also reduce the number of times people are in the hospital and the number of days in the hospital for a crisis.
Possibly Effective for
- Burns. Administering glutamine through a feeding tube seems to reduce the risk of developing severe infections and might reduce the chance of death in people with severe burns. Administering glutamine intravenously (by IV) seems to decrease the risk of some infections in people with severe burns. But it does not seem to decrease the risk of death.
- Critical illness (trauma). While some conflicting results exist, most research shows that glutamine keeps bacteria from moving out of the intestine and infecting other parts of the body after major injuries. Glutamine might also reduce the risk of hospital-acquired infections in people who are critically ill. Glutamine seems to prevent hospital-acquired infections better when given intravenously (by IV) rather than by a feeding tube. Overall, glutamine does not seem to reduce the risk of death in critically ill people.
- Involuntary weight loss in people with HIV/AIDS. Taking glutamine by mouth seems to help HIV/AIDS patients absorb food better and gain weight. Doses of 40 grams per day seem to produce the best effect.
- Recovery after surgery. Giving glutamine intravenously (by IV) along with intravenous nutrition seems to reduce the number of days spent in the hospital after surgery, especially major abdominal surgery. It might also help prevent hospital-acquired infections after elective or emergency surgery. Giving glutamine by IV along with intravenous nutrition might also reduce the risk of infection and improve recovery after bone marrow transplants. However, not all people who receive bone marrow transplants seem to benefit. Glutamine does not seem to reduce the risk of death after any type of surgery.
Possibly Ineffective for
- Athletic performance. Taking glutamine by mouth doesn't seem to improve athletic performance.
- A type of inflammatory bowel disease (Crohn disease). Taking glutamine by mouth doesn't seem to improve symptoms of Crohn disease.
- An inherited condition that can lead to kidney or bladder stones (cystinuria). Taking glutamine by mouth doesn't seem to improve cystinuria.
- Infants weighing less than 2500 grams (5 pounds, 8 ounces). Giving glutamine to infants with low weight at birth doesn't seem to improve feeding tolerance. It also doesn't appear to increase the rate of growth. Giving glutamine to low birth weight infants during the first 30 days of life also doesn't improve thinking skills, motor skills, or behavior by school age.
- A group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy). Research shows that taking glutamine by mouth doesn't improve muscle strength in children with muscular dystrophy
- Growth and development in premature infants. Glutamine doesn't appear to improve growth or prevent illness and early death in premature infants.
- Diarrhea caused by radiation therapy. Research shows that taking glutamine by mouth doesn't prevent diarrhea or reduce the severity of diarrhea caused by radiation in people with pelvic cancers.
Insufficient Evidence for
- Diarrhea in people taking drugs to treat HIV/AIDS (antiretroviral-associated diarrhea). Early research shows that taking glutamine by mouth reduces the severity of diarrhea in people with HIV who are taking the drug nelfinavir.
- Diarrhea caused by cancer drug treatment. Some early research shows that glutamine helps prevent diarrhea after chemotherapy. But not all research findings agree.
- Damage to the immune system caused by cancer drug treatment. There is some evidence that glutamine reduces damage to the immune system caused by chemotherapy. But not all research findings agree.
- Cystic fibrosis. Early research shows that taking glutamine by mouth doesn't increase protein gain in children with cystic fibrosis.
- Foot sores in people with diabetes. Taking a combination product containing glutamine and other ingredients doesn't seem to improve the healing rate of foot sores in people with diabetes.
- Diarrhea. One early study shows that taking glutamine by mouth reduces the duration of diarrhea in children. But taking glutamine by mouth along with conventional rehydration solutions doesn't seem to have an advantage over rehydration solutions alone.
- A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). Early research shows that taking glutamine by mouth for 8 weeks might help with symptoms of IBS. Glutamine seems to reduce stomach pain, improve quality of life, and reduce the number of bowel movements per day in people with IBS who mostly have diarrhea as a symptom.
- Lung cancer. Early research shows that taking glutamine by mouth for 12 months doesn't improve survival rates in people taking cancer drugs and receiving radiation therapy for lung cancer. But this study may have been too small to show a benefit. More research is needed.
- Obesity. Some early studies show that taking glutamine for 2-4 weeks might help reduce waist size in people who are overweight or obese. It's unclear if glutamine can help with weight loss. One small study in obese women shows that it can, while another in overweight and obese adults shows that it can't. It's not known if taking glutamine long-term has benefits for people who are overweight or obese.
- Withdrawal from heroin, morphine, and other opioid drugs. Taking a combination of glutamine and other ingredients might reduce the mood-related symptoms associated with opioid withdrawal.
- Swelling (inflammation) and sores inside the mouth (oral mucositis). In some people, taking glutamine by mouth seems to reduce soreness and swelling inside the mouth caused by chemotherapy. But it doesn't seem to benefit all chemotherapy patients. Some researchers think it works best in people with low glutamine levels during chemotherapy treatment.
- Muscle and joint pain caused by the drug paclitaxel. There is some evidence that glutamine might help to reduce muscle and joint pains caused by paclitaxel.
- Swelling (inflammation) of the pancreas (pancreatitis). An early study shows that giving glutamine intravenously (by IV) along with intravenous nutrition improves immune function but does not reduce the risk for complications or the amount of time spent in the hospital in people with pancreatitis.
- Bed sores (pressure ulcers). Taking a combination product containing glutamine and other ingredients doesn't seem to improve the healing rate of bed sores.
- Skin damage caused by radiation therapy (radiation dermatitis). Early research shows that taking glutamine doesn't reduce skin damage caused by radiation for head and neck cancers. But taking glutamine starting 1 week before and continuing 1 week after radiation for breast cancer might reduce the severity of skin damage.
- Swelling (inflammation) of the esophagus caused by radiation therapy. Early research shows that taking glutamine for 12 months lowers the chance of swelling of the esophagus in people receiving radiation therapy for lung cancer.
- Poor nutrient absorption that occurs when part of the small intestine is missing or removed (short bowel syndrome). Researchers have studied whether glutamine combined with growth hormone is effective in treating short bowel syndrome. This combination seems to help some patients become less dependent on tube feeding. But glutamine alone does not seem to be effective.
- Nerve damage caused by the drug vincristine. Taking glutamine daily during vincristine treatment seems to reduce nerve damage in children and young adults.
- Wound healing. Early research shows that taking glutamine by mouth in combination with antioxidants might reduce the time to wound closure in people with wounds caused by trauma. But it does not seem to reduce the number of days in the hospital.
- A condition caused by a poor diet or the body's inability to absorb nutrients.
- A type of inflammatory bowel disease (ulcerative colitis).
- Alcohol use disorder.
- Attention deficit-hyperactivity disorder (ADHD).
- Stomach ulcers.
- Other conditions.
When given by IV: Glutamine is LIKELY SAFE for most adults when given by IV in doses up to 600 mg/kg of body weight daily.
Special Precautions and Warnings
Pregnancy and breast-feeding: Not enough is known about the use of glutamine during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Bone marrow transplants: Giving glutamine by IV might increase the risk of mouth ulcers or death in people receiving bone marrow transplant. Until more is known, avoid giving glutamine by IV to these patients. Swishing glutamine in the mouth and then swallowing might be beneficial for these patients.
Cirrhosis: Glutamine could make this condition worse. People with this condition should avoid glutamine supplements.
Severe liver disease with difficulty thinking or confusion (hepatic encephalopathy): Glutamine could make this condition worse. Do not use it.
Mania, a mental disorder: Glutamine might cause some mental changes in people with mania. Avoid use.
Monosodium glutamate (MSG) sensitivity: If you are sensitive to MSG, you might also be sensitive to glutamine, because the body converts glutamine to glutamate.
Seizures: There is some concern that glutamine might increase the likelihood of seizures in some people. Avoid use.
Lactulose interacts with GLUTAMINE
Lactulose helps decrease ammonia in the body. Glutamine is changed into ammonia in the body. Taking glutamine along with lactulose might decrease the effectiveness of lactulose.
Medications for cancer (Chemotherapy) interacts with GLUTAMINE
There is some concern that glutamine might decrease the effectiveness of some medications for cancer. But it is too soon to know if this interaction occurs.
Medications used to prevent seizures (Anticonvulsants) interacts with GLUTAMINE
Medications used to prevent seizures affect chemicals in the brain. Glutamine may also affect chemicals in the brain. By affecting chemicals in the brain, glutamine may decrease the effectiveness of medications used to prevent seizures.
Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.
Be cautious with this combination
- For burns: 0.35-0.5 grams per kilogram body weight each day or 4.3 grams every four hours.
- For critical illness (trauma): Glutamine has been given in a liquid feed at 0.2-0.6 grams per kilogram body weight each day or at a dose of 20 grams per day has been used. It is usually given for at least 5 days.
- For sickle cell disease: 5-15 grams of prescription glutamine taken twice daily for 48 weeks in people with sickle cell disease 5 years of age or older has been used with or without the conventional medication hydroxyurea.
- For involuntary weight loss in people with HIV/AIDS: 14-40 grams of glutamine per day has been used in combination with other nutrients.
- For burns: 0.57 grams of glutamine per kilogram body weight each day has been used for 30 days.
- For critical illness (trauma): 0.3-0.5 grams per kilogram or 18-21 grams of glutamine compounds have been given daily, sometimes with hormones.
- For recovery after surgery: 0.57 grams of glutamine per kilogram body weight has been used after bone marrow transplantation. Also, 20 grams of glutamine per day or 0.3-0.4 grams per kilogram body weight has been used in people undergoing surgery. Sometimes glutamine is given in the form of glutamine dipeptide. Typically, 18-30 grams of glutamine dipeptide is used. This amount is equivalent to 13-20 grams of glutamine.
- For critical illness (trauma): 0.3 grams per kilogram has been given daily.
- For sickle cell disease: 5-15 grams of prescription glutamine taken twice daily for 48 weeks in children 5 years of age or older has been used.
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