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hipertiroza in L-carnitin

Pozdravljeni!

Zdravim se za antoimuno vnetje ščitnice-hipertiroza, sedaj jemljem 5mg Athyrazola (zdravim se 9 mesecev, prej sem imela TSH 0,0008, pred mesece dni se je stanje izboljšalo na TSH 3,5 zato so mi zmanjšali dozo zdravil na polovičko Athyrazola na dan) in 2x po 10mg pranolola dnevno, zaradi pospešenega bitja srce,stiskanje v srcu- tahekardija. Zanima me, če lahko jemljem L-carnitne, saj sem slišala, da lajša simptome hipertiroze in zelo pomaga pri stiskanju v srcu, v kakšnih količinah ga lahko jemljem in koliko časa?

Hvala.

lp

Spoštovani,

L- carnitine je prehranski proteinski dodatek, ki nima učinka niti na vašo ščinično bolezen niti na hipertirozo. Glede na to, da se je z zdravljenjem delovanje vaše ščitnice popolnoma normaliziralo, pravzaprav ne bi smeli imeti težav s simptomi hipertiroze. Učinki, ki jih opisujete v povezavi z L-carnitinom so najverjetneje vezani na ti. placebo učinek. Ta protein je del normalne zdrave prehrane, glede dodajanja, ki je še v varnih mejah, pa nimam izkušenj. Najbolje bi bilo, da preverite pri proizvajalcu.

lep pozdrav

******************************************* doc. dr. Katja Zaletel, dr. med.

Pozdravljeni,

imam podobno vprašanje na to temo.

Sem stara 64let in vsako leto opravljam teste ščitniških hormonov.
Trenutno jemljem Evterox 75mg, ker imam prenizko delovanje ščitnice (nivo TSH pred enim letom ob jemanju 50mg Evteroxa je bil 0,003).

Ker sem vsakodnevno telesno aktivna in sem v fazi postopnega hujšanja me zanima ali lahko vseeno jemljem L-Karnitin kljub temu, da imam omenjene težave s ščitnico?

Koliko L-Karnitina dnevno bi mi maksimalno priporočali pred telovadbo?

Hvala in lep pozdrav,
Marija

Spoštovani!

L-karnitin je beljakovina, ki je sestavni del normalne zdrave prehrane. Pri strezno urejeni hipotirozi ne vidim zadržka za njegovo jemanje. Glede optimalnega odmerka priporočam, da preverite pri proizvajalcu. Ne priporočam prekoračitve dnevno priporočene količine za odraslo osebo.

Lp

************************** Asis.dr. Edvard Pirnat, dr. med., spec. internist - tirolog

Spoštovani,

v zvezi z vplivom carnitina na delovanje T3 in T4 na določena tkiva (in ne na ščitnico) sem na spletu našel naslednji prispevek:

http://autoimmunedisease.suite101.com/article.cfm/l_carnitine_for_graves__disease

Studies dating back to the 60’s in animals and recently in humans suggest that the amino acid L-carnitine blocks the effects of excess thyroid hormone in some of the body’s tissues. L-carnitine does not affect the thyroid gland itself but effectively reduces symptoms of hyperthyroidism in the autoimmune hyperthyroid disorder Graves’ disease. The primary effects of L-carnitine are on the activity of thyroid hormone. Specifically, L-carnitine blocks the entry of excess thyroid hormone into the cell nucleus of liver cells, neurons (cells of the brain and central nervous system), and theally associated with hyperthyroidism.
Overall, study results show that the addition of 1-3 grams of oral carnitine daily is an effective tool for reducing symptoms of nervousness, heat intolerance, insomnia, emotional instability, tremors, and excessive sweating in hyperthyroidism. Used alone or in conjunction with anti-thyroid drugs or alternative medicine, L-carnitine is a welcome addition to any program used for the management of hyperthyroidism.
Physiological Effects of L-Carnitine
L-Carnitine’s effects are related to its ability to inhibit the entry of both thyroxine (T4) and triiodothyronne (T3) into the cell nucleus. This is important because entry into the cell nucleus is essential for thyroid hormone to cause the effects commonly associated with hyperthyroidism. In clinical observations, L-carnitine reduces effects in both mild hyperthyroidism and in the severe form of hyperthyroidism known as thyroid storm.
Studies showed benefits starting with the second week of treatment using 2-4 grams of L-carnitine daily including reduction of goiter size, I-131 uptake, liver enzyme levels, and an improvement in eye symptoms including ophthalmopathy. In addition L-carnitine has a beneficial effect on muscle function, strength, and bone mineralization.
Because hyperthyroidism depletes the body of L-carnitine and other nutrients, doses of L-carnitine as high as 4 grams daily are not associated with toxicity, teratogenicity (effects on offspring), contraindications or interactions with other drugs. A naturally occurring substance, L-carnitine is a known protector of mitochondrial function in the body’s cells. Studies of patients with both hypothyroidism and hyperthyroidism show decreased levels of L-carnitine in muscles. These deficiencies are known to contribute to muscle fatigue in both conditions.
In one study involving 50 patients with hyperthyroidism, L-carnitine caused mild nausea in two patients during the first week of treatment. These symptoms did not require a discontinuation of treatment, and they subsided within a few days. L-carnitine caused no significant alterations in blood counts, serum proteins, bilirubin levels, blood sugar levels or urine chemistry levels.
L-carnitine is best absorbed when used as a supplement containing L-acetyl-carnitine. L-acetyl-carnitine is available at most health food stores, and is effective for treating hyperthyroidism related to Graves’ disease, toxic multinodular goiter, and the excessive use of thyroid replacement hormone.

Resources:
Salvatore Benvenga, Rosaria Ruggeri, Antonia Russo, Daniela Lapa, Alfredo Campenni and Francesco Trimarchi, Usefulness of L-Carnitine, a Naturally Occurring Peripheral Antagonist of Thyroid Hormone Action, in Iatrogenic Hyperthyroidism: a Randomized, Double-Blind, Placebo-controlled Clinical Trial. The Journal of Clinical Endocrinology and Metabolism, 86(8); 201:3579-3594.
Salvatore Benvenga, Antonino Amato, Menotti Calvani, and Francesco Trimarchi, Effects of Carnitine on Thyroid Hormone Action, Annals of the New York Academy of Sciences, Nov 2004, 1033:158-167.
Stephen DeFelice, Carnitine for the Treatment of Hyperthyroidism and Carnitine and Thyroid Hormone, A Potential Treatment for Obesity, The Foundation for Innovation in Medicine, Nov 1, 2002.

Lep pozdrav!

Spoštovani!

Hvala za posredovane informacije. Vsekakor je potrebno navedene informacije interpretrati z veliko meri previdnosti. Potrebne bodo prospektivne klinične študije na dovolj veliki skupini bolnikov, da bo možo potrditi ali ovreči navedene učinje l-karnitina.

Lp

************************** Asis.dr. Edvard Pirnat, dr. med., spec. internist - tirolog

Ali so bile kakšne študije na temo povezave med vsebnostjo l-carnitina v krvi in hipertirozo, opravljene?

Spoštovani!

Poročali so, da lahko l-karnitin vpliva na simptome hipertiroze, ni pa bil učinek preverjen v večjih kliničnih študijah.

Lp

************************** Asis.dr. Edvard Pirnat, dr. med., spec. internist - tirolog

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