Glutamine

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Latest Edit: Hector 2014-03-17 (EDT)

See Also Amino Acids

Glutamine is made from glutamic acid which is considered a non-essential amino acid. Glutamine crosses the blood brain barrier quite easily, whereas glutamic acid does not. Glutamine is found in high concentrations within the blood but is also high in skeletal muscles, the lungs, the liver, the brain, and the stomach. The body requires more glutamine than can be obtained through the diet during times of catabolism such as during injury, cancer, surgery, endurance training, and infection [1]. Glutamine has many important functions within the body. It is important for intestinal repair and protection, acid-base balance, glutathione repletion, protein sparing in the muscle, and immune support.[2].

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Food Sources

The following foods have the highest source of glutamine:

Uses

The following are the primary uses for glutamine.[1], [2]

  • Alcoholism: Supplementation with glutamine can decrease one's use of alcohol as well as one's craving for alcohol.
  • Intelligence: Studies have also shown positive results in terms of the use of glutamine and glutamic acid to increase I.Q.
  • Gastrointestinal Disease: Glutamine is what the cells of the small intestine use as fuel. Many conditions of the gastrointestinal tract are caused by increased intestinal permeability also known as "leaky gut". If the cells lining the small intestine lose their integrity and ability to regulate what is able to pass, large proteins, bacteria, fungi, and other toxins can pass through which are not meant to enter the systemic circulation. This can lead to food allergies, heartburn, joint pain, and worsening of irritable bowel syndrome, ulcerative colitis, and Crohn's Disease. Glutamine supplementation can aid in repairing the gut barrier thus improving immune function and reducing the number of relapses in small intestine-related gastrointestinal diseases.
  • Infectious Diarrhea: Animal and human studies have shown positive results in terms of repair of gastrointestinal mucosal damage caused by infectious agents and toxins with the use of glutamine supplementation.
  • Postsurgical complications of the gastrointestinal tract: The trauma to the gastrointestinal mucosa that results after surgery of the GI tract can compromise its integrity which can lead to bacteria and endotoxins finding an easy pathway into systemic circulation and body tissues. Glutamine can help treat intestinal permeability that results from GI surgery, thus modulating the systemic inflammatory response in early post-operative patients.
  • Peptic Ulcers: Cabbage juice has shown positive results in treating peptic ulcers; it is probably the glutamine content in the cabbage juice that provides this therapeutic benefit.
  • Healing wounds and injuries: Glutamine supplementation can improve the healing function of cells by promoting cell growth. Adding arginine and omega-3 essential fatty acids to the regime can further decrease the time to heal and increase the healing process. Individuals under high amounts of stress, including endurance athletes, may find that healing takes longer and may require supplemental doses of glutamine.
  • Severe Burns: Plasma glutamine is found to be low in severe burn patients. Glutamine supplementation given to burn patients helps to decrease intestinal permeability, increase wound healing and decrease the amount of time spent in hospital.
  • AIDS: Individuals infected with the HIV virus have lower levels of glutamine in their blood which leads to muscle-wasting, "leaky gut", and malabsorption. All of these can worsen the outcome for an individual with HIV.
  • Cancer: There is much controversy around the issue of using glutamine during the treatment of cancer. Studies have shown that cancer cells accumulate glutamine, which steals it from muscles causing muscle wasting. It is also thought that cancer cells use glutamine as a fuel source. Professional guidance is required when considering the use of glutamine as part of a comprehensive cancer treatment protocol.
  • Chemotherapy and Radiation Side Effects: Chemotherapy and radiation is targeted at rapidly dividing cells such as cancer cells but also inadvertently attacks intestinal cells. Glutamine appears to aid in mitigating the negative GI side effects associated with cancer treatment. Furthermore, glutamine supplementation has also shown positive results in treating mouth sores associated with the radiation treatment of head and neck cancers.
  • Cardiovascular Disease: Animal studies have shown positive results in terms of glutamine supplementation as an effective treatment for the recovery of cardiac ischemic injury. Glutamine can also help protect the heart during chemotherapy. Furthermore, glutamine can aid in the treatment of gut ischemia which can result from cardiac bypass.
  • Exercise and Weight Lifting: Glutamine has an anabolic effect meaning that it helps to build skeletal muscles. Some believe that glutamine supplementation for avid exercisers and weight lifters is beneficial due to its effect on glutathione reserves, protein catabolism, and intestinal integrity.
  • Glutamine can be used to treat stomatitis caused by chemotherapy or radiation with a solution of glutamine and water or saline a swishing and swallowing. Fresh preparation should be made as glutamine is unstable in water [3].

Prescribing Considerations

  • Glutamine is available in capsules, tablets, and powder form. It is also available in medical foods for oral and enteral nutrition use and in a dipeptide form for parenteral nutrition use.
  • The recommended dosages varies based on age and health status. The dosage of oral glutamine can vary from 1 gram/day to 30 grams/day. [4] To determine what your specific requirements are talk to your naturopathic doctor or other trained medical professional.

Safety

  • General: Glutamine, even at higher doses, is well tolerated.

Drug Interactions

Drug Interactions include: [2]

  • Cancer Treatment - Glutamine does not appear to change the efficacy of cancer drugs, rate of relapse, or progression of malignancy.
  • Antiseizure Drugs (Phenobarbital, Phenytoin, Carbamazepine, Primidone, and Valproic Acid) - These drugs work to block glutamate; since glutamine can convert to glutamate, clinicians should be cautious when co-administrating antiseizure drugs and glutamine.

References

  1. 1.0 1.1 Hoffer Abram, Prousky Jonathan (2006) Naturopathic Nutrition, A Guide to Nutrient-Rich Food & Nutritional Supplements for Optimum Health, CCNM Press
  2. 2.0 2.1 2.2 Pizzorno Joseph E, Murray Michael T (2005) Textbook of Natural Medicine, Third Edition, Elsevier
  3. Hendler Sheldon S, Rorvik David (Editors) (2008) PDR for Nutritional Supplements, Medical Economics Company Inc.
  4. Gaby Alan (2011) Nutritional Medicine Fritz Perlberg Publishing.