How do I avoid secondary carnitine deficiency related to Valproate Acid treatment?

Asked by: Sheila Williams

Does valproic acid cause carnitine deficiency?

Carnitine is an essential amino acid necessary in beta-oxidation of fatty acids and energy production in cellular mitochondria. It has been hypothesized that valproic acid may induce a carnitine deficiency in children and cause nonspecific symptoms of deficiency, hepatotoxicity, and hyperammonemia.

How is valproate toxicity treated?

Treatment / Management

Therapy for patients with valproate toxicity is mainly supportive and includes initial stabilization and resuscitation. Measures include maintenance of airway, breathing, and circulation. Establish early IV access as intravenous fluid administration for the patients presenting with hypotension.

What is the antidote for valproate?

Meropenem as an antidote for intentional valproic acid overdose.

Can carnitine deficiency cause seizures?

Maternal carnitine deficiency that occurs during the perinatal period may manifest as secondary epilepsy with cerebral injury in neonates.

What are the symptoms of carnitine deficiency?

What are the symptoms of carnitine deficiency?

• Decreased or floppy muscle tone or muscle weakness.
• Tiredness (fatigue)
• Irritability.
• Delayed movement (motor) development.
• Poor feeding in a baby.
• Symptoms of low blood sugar (hypoglycemia) if the liver is affected.

How do I get off valproic acid?

Do not stop taking valproic acid suddenly, unless your doctor tells you to. You’re unlikely to get any extra symptoms when you stop taking this medicine. However if you’re taking it for bipolar disorder or to prevent migraine, your condition could get worse for a short time after you stop taking the medicine.

What happens if valproic acid levels are high?

Gastrointestinal symptoms such as nausea, vomiting, diarrhea. Dizziness. Unusual weight gain or loss. Tremors.

What is the protein binding of valproate?

Because valproic acid (VPA) is highly bound to plasma protein, several variables affecting binding will significantly alter the quantity of free drug which is pharmacologically active. Therefore, total VPA plasma concentrations do not reflect the therapeutic strength of the drug in tissue.

Is there an antidote for sodium valproate?

No clinically established antidotes capable of immediately reversing toxic effects exist for the treatment of valproic acid overdose. However, L-carnitine and naloxone have both been used in a number of cases with varying results.

Can you take L-carnitine if you have epilepsy?

Valproic acid (Depakote): The antiseizure medication valproic acid may lower blood levels of carnitine. Taking L-carnitine supplements may prevent any deficiency and may also reduce the side effects of valproic acid. However, taking carnitine may increase the risk of seizures in people with a history of seizures.

Is L-carnitine good for epilepsy?

It has been suggested through both the product monograph [17], and online pharmacy databases [15], [16], that l-carnitine supplementation can induce seizure activity in both patients with and without known epilepsy.

Is carnitine deficiency genetic?

Primary carnitine deficiency is inherited in an autosomal recessive pattern , which means both copies of the gene in each cell have mutations. Most often, the parents of an individual with an autosomal recessive disorder are carriers, which means they each carry one copy of the mutated gene.

What causes secondary carnitine deficiency?

Secondary carnitine deficiency can be caused by increased acylcarnitinie and carnitine urinary losses, treatment with certain medicines, a number of inherited metabolic disorders, poor diet or malabsorption of carnitine, from increased renal tubular loss of free carnitine (Fanconi syndrome), haemodialysis, peritoneal …

How do you increase carnitine naturally?

Animal products like meat, fish, poultry, and milk are the best sources. In general, the redder the meat, the higher its carnitine content. Dairy products contain carnitine primarily in the whey fraction [1,3,5]. The carnitine content of several foods is listed in Table 1.

Is carnitine deficiency curable?

CDSP is treatable by the daily use of L-carnitine supplements. Without early detection and treatment, an affected child may experience low blood sugar (hypoglycdemia), seizures, heart muscle weakness (cardiomyopathy) that can be life-threatening. Newborn screening is available for CDSP.

How is secondary carnitine deficiency diagnosed?

Diagnosing secondary carnitine deficiency

The physical exam may include a neurological exam. Tests may also be done, such as: Blood tests. These are done to check the levels of carnitine in the blood.

How is carnitine uptake defect treated?

Prescription L-carnitine supplements is the main treatment for carnitine uptake defect (CUD). L-carnitine is a substance that is naturally produced in the body, but your baby’s body might not make enough of it. These supplements help break down fats and get rid of harmful waste substances that build up in the body.

What foods have L-carnitine in them?

Meat, poultry, fish, and dairy products are the richest sources of L-carnitine, while fruit, vegetables, and grains contain relatively little L-carnitine.

What is the best form of L-carnitine?

L-carnitine L-tartrate: This form is most effective for exercise performance. Doses vary from 1,000–4,000 mg per day. Propionyl-L-carnitine: This form is best for improving blood flow in those with high blood pressure or related health conditions. Doses vary from 400–1,000 mg per day.

Do eggs have carnitine?

The main dietary sources of choline and carnitine are red meat, poultry, fish, dairy products and eggs (yolks).

Does yogurt have carnitine?

While most dairy is also lower than beef and pork in terms of L-carnitine, concentrated sources of whey, such as certain yogurts, protein supplements, and bars, will have higher levels of L-carnitine (or even add it as a supplement.)

Does salmon have carnitine?

Salmon contained about 12 times less l-carnitine than beef but except in smoked salmon, cooking or freezing did not alter l-carnitine content. This study confirms the important role that meet products play for providing adequate amount of l-carnitine to the human body.

Is cheese good for adrenal fatigue?

Packed with nutrition, cheese can help curb salty and fatty food cravings, reduce stubborn fat, help nourish adrenals, and restore energy levels in adrenal fatigue.