Glutamine

Uses

Wound healing and recovery from illness

When the body is stressed (from injuries, infections, burns, trauma, or surgical procedures), it releases the hormone cortisol into the bloodstream. High levels of cortisol can lower your body's stores of glutamine. Several studies show that adding glutamine to enteral nutrition (tube feeding) helps reduce the rate of death in trauma and critically ill people. Clinical studies show that taking glutamine supplements strengthens the immune system and reduce infections, particularly infections associated with surgery. Glutamine may help prevent or treat multiple organ dysfunction after shock or other injuries among people in the intensive care unit. Glutamine supplements may also help in the recovery of severe burns.

Inflammatory bowel disease (IBD)

Glutamine helps protect the lining of the gastrointestinal tract known as the mucosa. For that reason, some researchers believe that people who have IBD (ulcerative colitis and Crohn disease) may not have enough glutamine. However, two clinical trials found that taking glutamine supplements did not improve symptoms of Crohn disease. More research is needed. In the meantime, ask your doctor when deciding whether to use glutamine for IBD.

HIV/AIDS

People with HIV or AIDS often experience severe weight loss (particularly loss of muscle mass). A few studies of people with HIV and AIDS have found that taking glutamine supplements, along with other important nutrients, including vitamins C and E, beta-carotene, selenium, and N-acetylcysteine, may increase weight gain and help the intestines better absorb nutrients.

Athletes

Athletes who train for endurance events (like marathons) may reduce the amount of glutamine in their bodies. It is common for them to catch a cold after an athletic event. Some experts think that may be because of the role glutamine plays in the immune system. For this select group of athletes, one study showed that taking glutamine supplements resulted in fewer infections. The same is not true, however, for exercisers who work out at a moderate intensity.

Cancer

Many people with cancer have low levels of glutamine. For this reason, some researchers speculate that glutamine may be helpful when added to conventional cancer treatment. Supplemental glutamine is often given to malnourished cancer patients undergoing chemotherapy or radiation treatments, and sometimes used in people undergoing bone marrow transplants.

Glutamine seems to help reduce stomatitis (an inflammation of the mouth) caused by chemotherapy. Some studies suggest that taking glutamine orally may help reduce diarrhea associated with chemotherapy.

More clinical research is needed to know whether glutamine is safe or effective to use as part of the treatment regimen for cancer.

Dietary Sources

Dietary sources of glutamine include plant and animal proteins such as beef, pork, poultry, milk, yogurt, ricotta cheese, cottage cheese, raw spinach, raw parsley, and cabbage.

Available Forms

Glutamine, usually in the form of L-glutamine, is available by itself, or as part of a protein supplement. These come in powders, capsules, tablets, or liquids.

Standard preparations are typically available in 500 mg tablets or capsules.

How to Take It

Take glutamine with cold or room temperature foods or liquids. It should not be added to hot beverages because heat destroys glutamine.

Pediatric

For children 10 years and younger: DO NOT give glutamine to a child unless your pediatrician recommends it as part of a complete amino acid supplement.

Adult

Speak with your health care provider regarding dosing instructions.

Precautions

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider. You should only take high doses under the supervision of a physician.

Glutamine powder should not be added to hot beverages because heat destroys glutamine. Glutamine supplements should also be kept in a dry location.

People with kidney disease, liver disease, or Reye syndrome (a rare, sometimes fatal disease of childhood that is generally associated with aspirin use) should not take glutamine.

People who have psychiatric disorders, or who have a history of seizures, should use caution when considering supplementation with glutamine. Some researchers feel that taking glutamine may worsen these conditions.

Many elderly people have decreased kidney function, and may need to reduce their dose of glutamine.

Glutamine is different from glutamate (glutamic acid), monosodium glutamate, and gluten. Glutamine should not cause symptoms (headaches, facial pressure, tingling, or burning sensation) associated with sensitivity to monosodium glutamate. People who are gluten sensitive can use glutamine without problems. However, some people may be sensitive to glutamine, which is completely separate from gluten.

Possible Interactions

Lactulose: Glutamine supplementation can increase ammonia in th body, so taking glutamine may make lactulose less effective.

Cancer therapy: Glutamine may increase the effectiveness and reduce the side effects of chemotherapy treatments with doxorubicin, methotrexate, and 5-fluorouracil in people with colon cancer. Preliminary studies suggest that glutamine supplements may prevent nerve damage associated with a medication called paclitaxel used for breast and other types of cancers.

However, laboratory studies suggest that glutamine may actually stimulate growth of tumors. More research is needed before researchers can determine whether it is safe to use glutamine if you have cancer. If you are receiving chemotherapy, you should never add supplements to your regimen without consulting your doctor.

Supporting Research

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Agostini F, Giolo G. Effect of physical activity on glutamine metabolism. Curr Opin Clin Nutr Metab Care. 2010;13(1):58-64.

Akobeng AK, Miller V, Stanton J, Elbadri AM, Thomas AG. Double-blind randomized controlled trial of glutamine-enriched polymeric diet in the treatment of active Crohn's disease. J Pediatr Gastroenterol Nutr. 2000;30(1):78-84.

Antoon AY, Donovan DK. Burn Injuries. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. Philadelphia, PA: W.B. Saunders Company; 2000:287-294.

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Daniele B, Perrone F, Gallo C, et al. Oral glutamine in the prevention of fluorourcil induced intestinal toxicity: a double blind, placebo controlled, randomized trial. Gut. 2001;48:28-33.

Decker GM. Glutamine: indicated in cancer care? Clin J Oncol Nurs. 2002;6(2):112-115.

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Field CJ, Johnson IR, Schley PD. Nutrients and their role in host resistance to infection. J Leukoc Biol. 2002 Jan;71(1):16-32.

Furukawa S. Saito H, Inoue T, et al. Supplemental glutamine augments phagocytosis and reactive oxygen intermediate production by neutrophils and monocytes from postoperative patients in vitro. Nutrition. 2000;1695):323-329.

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Lecleire S, Hassan A, Marion-Letellier R, Antonietti M, Savoye G, et al. Combined glutamine and arginine decrease proinflammatory cytokine production by biopsies from Crohn's patients in association with changes in nuclear factor-kappaB and p38 mitogen-activated protein kinase pathways. J Nutr. 2008 Dec;138(12):2481-6.

Lin JJ, Chung XJ, Yang CY, Lau HL. A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn. Burns. 2013;39(4):565-70.

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Vidal-Casariego A, Calleja-Fernandez A, de Urbina-Gonzalez JJ, Cano-Rodriguez I, Cordido F, Ballesteros-Pomar MD. Efficacy of glutamine in the prevention of acute radiation enteritis: a randomized controlled trial. JPEN J Parenter Enteral Nutr. 2014;38(2):205-13.

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