Glutamine: Benefits, Dosage, Contraindications
Other name(s)
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Scientific name(s)
L-glutamine
Family or group:
Amino Acids
Indications
Rating methodology
EFSA approval.
Sickle Cell Disease ✪✪✪✪✪
Oxidative stress contributes to the effects of sickle cell disease. Glutamine has an antioxidant effect by increasing the reduced form of nicotinamide adenine dinucleotide (NAD) in sickle erythrocytes (NAD acts as an electron carrier in redox reactions, with the reduced form acting as a reducer). In some countries (the United States Food and Drug Administration), the administration of glutamine powder is approved to reduce acute complications of sickle cell disease in adults and children 5 years and older. Taking 5 to 15 grams of glutamine (0.3 grams/kg of body weight) orally twice a day for 48 weeks in sickle cell patients aged 5 and older, with or without hydroxycarbamide, reduces the frequency of painful crises by 25% to 30%, the incidence of acute chest syndrome by 15%, the number of hospitalizations by 33%, and the number of days of hospitalization by 40% compared to placebo.
Posologie
Oral
5 - 15 g
48 - weeks
Adults, Children
powder
Burns ✪✪✪✪✪
Some clinical research shows that the administration of enteral nutrition associated with glutamine at a rate of 0.35 to 0.5 gram/kg per day for 12 to 14 days, 24 to 48 hours after hospitalization for serious burns (excluding inhalation burns) reduces the length of hospital stay by 6 to 9 days and may shorten wound healing compared to control enteral nutrition. Other clinical research shows that the administration of enteral nutrition supplemented with 4.3 grams of glutamine every 4 hours starting 24 hours after a burn, decreases the risk of mortality by 83% and the risk of Pseudomonas infections, in cases of severe burns (including inhalation burns).
Posologie
Oral
0.35 - 0.5 g/Kg
14 - days
powder
Reduced mortality and infectious morbidity in adult burn patients receiving enteral glutamine supplementation: a prospective, controlled, randomized clinical trial.
The effect of additional enteral glutamine on plasma levels, intestinal function, and outcome in severe burns: a randomized controlled clinical trial, double-blind.
A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn.
HIV Infection ✪✪✪✪✪
Oral intake of glutamine appears to improve intestinal absorption of nutrients, decrease intestinal permeability, and increase weight gain in individuals with AIDS. Doses of 40 grams per day seem to have the best effect. Lower doses (14 grams per day for 8 weeks) may also be effective when used in combination with arginine and hydroxymethylbutyrate (a leucine metabolite). Furthermore, clinical research shows that oral glutamine at 30 grams per day for 10 days reduces the severity of diarrhea associated with nelfinavir (an antiretroviral) compared to placebo, in HIV-infected patients.
Posologie
Oral
14 - 40 g
8 - weeks
powder
Synergies
A double-blind placebo-controlled pilot study of glutamine therapy for abnormal intestinal permeability in patients with AIDS.
Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study.
Convalescence ✪✪✪✪✪
Various clinical studies have evaluated the effect of glutamine on the risk of infectious complications in critically ill patients. Some studies show that glutamine reduces the risk of infectious complications in polytraumatized or operated patients. Analyses of these clinical trials and others suggest that glutamine supplementation reduces the risk of nosocomial infections in critically ill patients by 15% to 18%. Supplemental enteral nutrition with glutamine at a rate of 20g/day or 0.2 to 0.6 grams/kg/day has been used. Generally, glutamine-enriched enteral nutrition is administered for at least 5 days.
Posologie
Oral
20 g
5 - days
powder
Metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids supplementation in immunocompromised patients.
Total parenteral nutrition supplemented with L-alanyl-L-glutamine dipeptide reduces infectious complications and glucose intolerance in critically ill patients: a multicenter, controlled, randomized, double-blind study in France.
Randomized study of clinical outcomes in critically ill patients receiving enteral nutrition supplemented with glutamine.
Effects of glutamine-supplemented diets on gut-associated immunology.
Randomised trial of glutamine-enriched enteral nutrition on infectious morbidity in patients with multiple trauma.
Obesity ✪✪✪✪✪
A clinical study in six obese women shows that taking 0.5 g/kg of glutamine per day for 4 weeks reduces body weight by 2.8 kg and waist circumference by 3.8 cm compared to baseline but does not improve glycemic indices. Another clinical trial in 36 overweight and obese patients shows that taking 30 g of glutamine per day for 2 weeks reduces waist circumference by 1.8 cm but does not improve body weight, body mass index, or glycemic indices compared to baseline values. Given the small size of the studies, the short treatment duration, and the conflicting results, the long-term effects of glutamine on body weight, waist circumference, and glycemic indices in these patients are unclear.
Posologie
Oral
0.5 g/Kg
4 - weeks
powder
Skin Healing ✪✪✪✪✪
Preliminary research shows that daily intake of 20 grams of oral glutamine in combination with 500 mg of ascorbic acid, 166 mg of vitamin E, 3.2 mg of beta-carotene, 100 µg of selenium, and 6.6 mg of zinc for 14 days in injured patients with healing disorders reduced the wound closure time by 29 days compared to placebo.
Posologie
Oral
20 g
14 - days
powder
Synergies
Irritable Bowel Syndrome ✪✪✪✪✪
Clinical research in patients with post-infectious irritable bowel syndrome dominated by diarrhea shows that taking 5 g of glutamine three times a day for 8 weeks results in symptom improvement with a decrease in stool frequency per day, compared to placebo. Taking glutamine also appears to reduce abdominal pain and improve the quality of life.
Posologie
Oral
15 g
8 - weeks
powder
Acid-Base Balance ✪✪✪✪✪
The use of glutamine as a nitrogen carrier is important for the excretion of nitrogenous waste and the maintenance of acid-base balance. The kidney uses glutaminase to hydrolyze glutamine and generate ammonia which will be excreted in the urine. The availability of ammonia facilitates the excretion of acid loads. In acidosis, both glutamine consumption and glutaminase activity are increased in the kidney.
Posologie
Oral
14 g
powder
Properties
Digestive Effect
The gastrointestinal tract is one of the largest users of glutamine in the body. Some data suggests that glutamine plays a regulatory role in the gut, affecting cell proliferation and differentiation. Glutamine depletion can lead to atrophy, ulceration, and necrosis of the intestinal epithelium. In an in vivo animal study, glutamine deficiency resulted in diarrhea, villous atrophy, mucosal ulcerations, and intestinal necrosis. In patients suffering from diarrhea, glutamine appears to increase water and electrolyte absorption, reduce water and sodium loss in the intestine, and improve intestinal permeability.
Usages associés
Immuno-modulator
Glutamine can enhance the function of stimulated immune cells. It seems to affect lymphocyte proliferation, cytokine production, bacterial destruction by neutrophils, and the phagocytic and secretory activities of macrophages. On the other hand, reduced glutamine concentrations after surgery appear to impair neutrophil and monocyte function, which might increase infection risk. Parenteral glutamine after surgery seems to improve the number and function of lymphocytes in some patients.
Usages associés
Essential
Glutamine has various biological roles, including acting as a nitrogen carrier between tissues alongside alanine, acting as a precursor to glutathione antioxidant, acting as a precursor for nucleotides, regulating acid/base metabolism, and being involved as a substrate in gluconeogenesis. It can also stimulate the production of L-citrulline and L-glycine by acting as a substrate.
Usages associés
Healing
After an injury, about one-third of the nitrogen mobilized for wound repair and the functioning of vital organs is derived from glutamine. In human research, an association of glutamine, arginine, and beta-hydroxy-beta-methylbutyrate increased collagen synthesis.
Usages associés
Bioenergetic
Glutamine oxidation can generate adenosine triphosphate (ATP) for cellular respiration. In fact, glutamine serves as the primary respiratory fuel in certain cells like enterocytes and lymphocytes. The total amount of cellular energy derived from glutamine depends on the degree of oxidation and the rate of glutamine usage. These factors, in turn, mostly depend on the relative proportions of available glutamine and glucose as well as the type of cell.
Musculoskeletal Effects
During physical stress, the body consumes more glutamine than skeletal muscles can produce. Progressive muscle breakdown can occur when the body tries to meet glutamine needs. Protein economy occurs when enough proteins and amino acids are provided to prevent muscle breakdown. Although glutamine is often used for muscle development, preliminary research suggests that glutamine does not affect muscle precursor cells, which would be responsible for muscle hypertrophy.
Antioxidant
There is substantial evidence suggesting that glutamine plays a key role in regulating glutathione synthesis, a powerful antioxidant. As a source of glutamate, glutamine provides one of the constituents of glutathione, but glutamine can also contribute to glutathione synthesis indirectly by exchanging intracellular glutamate (derived from glutamine) across the cell membrane for extracellular cysteine, another component of glutathione.
Usages associés
Neurological
Disruptions in glutamine metabolism and/or transport can contribute to changes in glutamatergic or GABAergic transmission associated with different pathological conditions in the brain, such as epilepsy and hepatic encephalopathy. Glutamine seems to affect neurotransmission by interacting with N-methyl-D-aspartate receptors (which are ionotropic receptors activated under physiological conditions by glutamate and glycine, essential to memory and synaptic plasticity).
Safety dosage
Adult from 18 years: 14 g (powder)
Glutamine is taken as a supplement, at a safe dose of 14 g/day (above dietary intake), without adverse effects. Furthermore, glutamine has been used safely in clinical research at doses up to 40 g per day or 1g/kg per day.
Child from 1 to 18 years: 700 mg/kg (powder)
Glutamine has been used in clinical research at a dose not exceeding 0.7g/kg per day in children from 1 to 18 years.
Interactions
Médicaments
Anticonvulsants: moderate interaction
Glutamine is metabolized into glutamate, an excitatory neurotransmitter, which can, theoretically, decrease the effects of anticonvulsant drugs.
Lactulose: moderate interaction
Theoretically, glutamine is metabolized into ammonia which can interfere with lactulose's anti-ammoniac effects.
Precautions
Pregnant woman: avoid
Avoid use due to lack of reliable and sufficient information.
Breastfeeding woman: avoid
Avoid use due to lack of reliable and sufficient information.
Contraindications
Cirrhosis: prohibited
In cirrhotic patients, oral glutamine increases serum ammonia levels.
Hepatic encephalopathy: prohibited
Theoretically, glutamine, which is metabolized into ammonia, could worsen hepatic encephalopathy.
Epilepsy: prohibited
Theoretically, excessive amounts of glutamine and its metabolite, glutamate, could lower the seizure threshold.
Cancer: prohibited
Glutamine metabolism is part of the cellular processes regulating tumor progression and reactivity to treatment in a number of cancers, including melanoma and breast cancer. Certain types of cancer heavily depend on glutamine as it provides the energy, carbon, and nitrogen properties, contributing to tumor growth and survival.
