From The Way Up Newsletter
BENEFITS OF
THE AMINO ACID L-GLUTAMINE
- Physicians
with an allopathic approach generally have their favorite armamentarium of
medicines with which they are comfortable & achieving predictable results.
Likewise holistic physicians have their favorite supplements which work to
achieve desired benefits.
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- In my medical
practice , L- Glutamine in one of the most frequently prescribed supplements.
This is not surprising since the importance of Glutamine is demonstrated by the
fact that it is the most abundant amino acid in circulation . The total body
Glutamine levels are in the range of 100,000 mg. In a healthy person, the
concentration of Glutamine in the blood is 3-4 times greater than all other
amino acids. It is actively transported, & metabolized in nearly all tissue.
Glutamine is a major fuel source & therefor energy source for the entire
body. It is particularly concentrated in the brain, skeletal muscles, gut
lining, lungs, heart, kidneys, & liver where it has multiple & critical
functions.
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- During years
of ordering blood tests to determine amino acid status, Glutamine is one of the
amino acids most usually below normal. In fact in my patient population of those
with either chronic illness or mood & cognitive symptoms it is rare to see
normal levels. Amino Acid testing may be obtained from Great Smokies Diagnostic lab at
http://www.gsdl.com or from Doctors
Data Lab at http://www.doctorsdata.com as well as other labs.
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- WHERE CAN
YOU GET L-GLUTAMINE?
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- We primarily
obtain Glutamine from the conversion of Glutamic Acid from food, though some
Glutamine is also in food. The average amount of Glutamine ingested daily in a
health diet is from 5,000-8,000 mg. Those foods with the highest content are
pork, poultry, eggs, & dairy proteins, wheat germ, oats & avocados. Or
you can get it as a free form amino acid supplement.
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- Much of the
dietary Glutamine is derived from the salt form of Glutamic Acid ( Glutamate).
This converts to Glutamine with the action of the enzyme Glutamine Synthetase.
Proper functioning of this enzyme requires adequate presence of
pyridoxal-5-phosphate ( the active form of vitamin B6), manganese, & other
vitamin/mineral co-factors. If
these are not present in sufficient quantities there can be a Glutamine
deficiency even in the presence of adequate dietary protein. Glutamate
also converts to GABA. Glutamine can conversely convert back to Glutamate &
to GABA with the help of the enzyme Glutaminase. They all can convert among
themselves as needed & depending upon the presence of adequate enzymes &
co-factors.
- GLUTAMINE
IMPROVES BRAIN FUNCTIONING
-
- Glutamine,
Glutamate, & GABA are all neurotransmitters which means they are chemical
messengers in the brain without which the brain could not function. GABA is a
calming neurotransmitter, Glutamate is a stimulating neurotransmitter, while
Glutamine is a modulator of the inhibitory & excitatory activity of the
other two.
-
- Glutamine is
highly concentrated in the brain , being 10-15 times more concentrated in the
cerebro-spinal fluid than in the blood. It is an important fuel for the brain,
& can provide adequate energy in the absence of glucose (the other major
brain fuel). For this reason it is helpful with focus, concentration, memory,
intellectual performance, alertness, attentiveness, improving mood, &
eliminating brain fog & cloudiness. It is one of the first nutrients I
prescribe when any of these symptoms are present.
-
- In animal
studies an inhibitor of the synthesis of Glutamine produced convulsions, &
Alzheimer’s or senile dementia-type changes in the brain.
-
- Research
suggests Glutamine may protect the brain cells in situations of decreased oxygen
supply. It also helps in the brain to detoxify ammonia.
-
- Those prone
to mania need to be careful with high doses of Glutamine for it can trigger
mania, as can any antidepressant substance.
- STABILIZES
BLOOD SUGAR & DECREASES ALCOHOL CRAVINGS
-
- Glutamine
does this by several mechanisms. When the blood sugar is low, Glutamine
suppresses insulin to stop the further decline of the sugar levels. It also
stimulates glycogen (a stored form of glucose) to be released to help increase
the blood sugar to normal levels.
-
- Further,
Glutamine is a glycogenic amino acid which means it can convert to sugar for
energy production, a process called gluconeogenesis. It is the most important
such substance.
These blood sugar stabilizing effects may partially explain
why it decreases alcohol cravings, as well as sugar cravings. In studies with
alcoholics, 2000-3000 mg 3 times daily decreased the desire to drink, decreased
anxiety, & improved sleep. It works best given between meals. Has been used
for this purpose in daily doses from 6000-15,000 mg in 3 divided doses. Use upon
arising, mid-morning & mid-afternoon between meals.
-
- Giving
Glutamine to rats decreased their voluntary alcohol consumption by 34%. When the
Glutamine was stopped, their alcohol consumption returned to baseline
levels.
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- Additionally,
Glutamine supports pancreatic growth & function, increases the production of
pancreatic enzymes, increases pancreatic weight, DNA, & protein content.
This would also stabilize blood sugar & indirectly improve overall
nutritional status..
- MAINTAINS
HEALTH /FUNCTIONING OF THE LINING OF THE GUT
-
- Glutamine
increases the growth & absorptive capacity & is the main fuel source for
the cells lining the intestinal tract. It is critical for the maintenance of
proper gut metabolism, structure & function. The cells lining the small
intestines consume Glutamine at a voracious rate, using up to 30% of the
circulatory pool. Glutamine deficiency results in hypoplasia of the intestinal
absorptive lining & dysfunction of the intestinal immune system. It helps
maintain normal Secretory IgA an immune substance in the gut.
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- Studies show
that Glutamine helps promote healing of impaired gut mucosa , such as with
ulcers, ulcerative colitis, & Crohn’s Disease. It enhances bowel function
when there has been partial removal of the intestines & improves overall
survival in gut originated severe infection.
-
- Certain
bacteria, fungi, & parasites can also impair the intestinal lining
disrupting the optimal intestinal barrier functioning, & causing increased
intestinal permeability ( the leaky gut syndrome). With increased permeability
there can be increased allergy reactions to foods, & increased
predisposition to autoimmune problems.
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- Also, the
bacteria which live in the GI tract can cross the disrupted mucosal barrier to
infect other organs in a process called bacterial translocation, so Glutamine
can help prevent this serious process.
- IMPORTANT
FOR MUSCLE FUNCTION & METABOLISM
-
- The
intracellular concentration of Glutamine in muscle is a regulator of muscle
protein synthesis or muscle building & supports muscle glycogen
accumulation. When there is Glutamine depletion, there is a breakdown in muscle.
Studies indicate Glutamine counteracts steroid-induced muscle atrophy.
-
- Skeletal
muscle is the largest organ in the body accounting for approximately 30-40% of
total body mass. A 150 pound male would ideally have about 60, 000 mg of
Glutamine in these muscles. Free stores of Glutamine in muscles exceed those of
any other amino acids( alanine & glycine are the other major muscle amino
acids).
-
- Surgical
& injury trauma , infections, burns, stress, cancer, acidosis, & most
major illnesses dramatically deplete & alter the production & interorgan
flow of Glutamine causing movement of Glutamine out of the muscle , altering
intestinal Glutamine metabolism, & also decreasing Glutamine blood levels.
Under these circumstances the net Glutamine consumption exceeds the production
& there is a decrease in muscle protein synthesis. This contributes to the
muscle wasting in severe illness & trauma. Research has shown a
statistically significant correlation between survival in severely infected
patients & the muscle intracellular Glutamine concentration. Supplying
Glutamine helps the metabolic processes associated with recovery.
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- HELPS WITH
WOUND HEALING
-
- The cells of
connective tissue in the body use Glutamine for protein & nucleic acid
synthesis & also for 30% of energy needs. These cells are called fibroblasts
. Glutamine is required for their proliferation & is therefore critical in
wound metabolism & healing.
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-
- HELPS
MAINTAIN ACID/ALKALINE BALANCE
-
- This is done
by the production & metabolism of Glutamine in the kidneys. The more severe
the acidosis is as in uncontrolled diabetes, starvation, kidneys disorders,
decreased oxygen in the body, fluid & electrolyte loss , the greater the
rate of Glutamine metabolism in the kidneys. When controlling acidosis the
kidneys consume enormous amounts of Glutamine & deplete muscle & other
stores . In acidotic conditions there is low Glutamine, low alanine & an
increased production of ammonia.
-
- In studies
2000 mg Glutamine produced a quick increase in plasma bicarbonate( which
elevates alkaline reserve) & an increase in growth hormone.
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- IS
CRITICAL IN PROTEIN METABOLISM
-
- Glutamine is
used in the liver & kidney to make urea & ammonia which are normal
breakdown products of protein, which are then excreted. Glutamine participates
in the detoxification of the ammonia.
-
- Excessive
Glutamine can elevate rather than decrease ammonia levels, as it should do. Such
excessive dose would be in the range of 40,000 mg for a 150 pound person-way
above any recommended amount.
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-
- GLUTAMINE
& CANCER
-
- In the area
of tumor growth, the evidence is unclear. Glutamine is highly used by rapidly
dividing cells such as blood cells, & those in the GI Tract & cancer
cells. It provides the nitrogen precursor for the synthesis of purines &
pyramidines essential to cell reproduction & division. So whether Glutamine
enrichment in amounts required to maintain normal metabolic balance will
accelerate tumor growth is not well known.
-
- Research has
provided varying information. One research report suggested Glutamine aggravated
muscle tumor( sarcoma) but this was not found in research on fibrosarcoma. Other
reports indicated Glutamine not only was beneficial for the patient with the
tumor, but did not stimulate tumor growth. It may very well depend upon the type
of the tumor.
-
- The fear is
that since the immune cells require Glutamine for proper functioning & since
an illness such as cancer depletes the body of Glutamine, such depletion will
impair immune function & interfere with the body fighting the cancer &
associated infections-if Glutamine is not given.
-
- Cancer
bearing rats were able to maintain normal immune function when given
Alanine-Glutamine enriched nutrition without increasing tumor size. According to
Rifat Latifi M.D. in “Amino Acids In Critical Care & Cancer” the general
consensus is “that an increased uptake of Glutamine by tumor cells does not
necessarily result in an increase in tumor size & the absence of accelerated
tumor growth may have been due to the maintenance of cell mediated immune
reactions of the host”
-
- As if this
weren’t definitive enough, animal studies showed Glutamine enhanced the
selectivity of antitumor drugs. It did so by helping to protect normal cells
from the chemotherapy while making the tumor cells more sensitive to the chemo.
Further, when Glutamine was given to patients undergoing abdominal or pelvic
radiation therapy it protected the intestinal mucosa from injury, accelerated
the healing of the radiated bowel & modulated the long term consequences of
radiation.
-
- So if you
have cancer consult with your doctor whether or not Glutamine supplementation
would be wise in your type of cancer.
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-
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- MISCELLANEOUS BENEFITS
-
- • Glutamine is important
for the synthesis of glutathione( an essential anti-oxidant) in the liver.
•
Adequate Glutamine helps to protect the lungs from toxic insult. • Glutamine
is needed for RNA (Genetic messenger material) synthesis • Essential for the
synthesis of Vitamin B3 .
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-
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- TOXICITY
-
- Studies using
high dose Glutamine have failed to demonstrate toxicity. However Glutamine
should be avoided in cases of acute liver failure & kidney failure.
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- DOSAGE
-
- As with any
free form amino acid, Glutamine should always be taken with
pyridoxal-5-phosphate which regulates the absorption, metabolism &
conversion of all amino acids.
The usual dose recommended in my practice is
4000-5000 mg anywhere from 1-3 times daily between meals & not later than
3pm.
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