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L Glutamine
Overview

Glutamine is an amino acid (a building block for proteins), found naturally in the body. Glutamine is the most abundant free amino acid in the body. Amino acids are the building blocks of protein. Glutamine is produced in the muscles and is distributed by the blood to the organs that need it. Glutamine might help gut function, the immune system, and other essential processes in the body, especially in times of stress. It is also important for providing "fuel" (nitrogen and carbon) to many different cells in the body. Glutamine is needed to make other chemicals in the body such as other amino acids and glucose (sugar).
Glutamine is used to counter some of the side-effects of medical treatments. For example, it is used for side-effects of cancer chemotherapy including diarrhea, pain and swelling inside the mouth (mucositis), nerve pain (neuropathy), and muscle and joint pains caused by the cancer drug Taxol. Some types of chemotherapy can reduce the levels of glutamine in the body. Glutamine treatment is thought to help prevent chemotherapy-related damage by maintaining the life of the affected tissues. Glutamine is also used to protect the immune system and digestive system in people undergoing radiochemotherapy for cancer of the esophagus.

Additionally, glutamine is used for improving recovery after bone marrow transplant or bowel surgery, increasing well-being in people who have suffered traumatic injuries, and preventing infections in critically ill people.

Some people use glutamine for digestive system conditions such as stomach ulcers, ulcerative colitis, and Crohn's disease. It is also used for depression, moodiness, irritability, anxiety, insomnia, and enhancing exercise performance.

People who have HIV (AIDS) sometimes use glutamine to prevent weight loss (HIV wasting). Glutamine is also used for attention deficit-hyperactivity disorder (ADHD), a urinary condition called cystinuria, sickle cellanemia, and for alcohol withdrawal support. Glutamine powder can be ordered through most wholesale drug suppliers. Glutamine for commercial use is made by a fermentation process using bacteria that produce glutamine.
After surgery or traumatic injury, nitrogen is necessary to repair the wounds and keep the vital organs functioning. About one third of this nitrogen comes from glutamine. If the body uses more glutamine than the muscles can make (i.e., during times of stress), muscle wasting can occur. This can occur in people with HIV/AIDS. Taking glutamine supplements might keep the glutamine stores up.

What is glutamine?

L_Glutamine
Other names
2-Amino-4-carbamoylbutanoic acid
 

Scientifically speaking, glutamine is one of the 20 amino acids formed by the human body. Glutamine is considered a non-essential amino acid because it can be derived from glutamic acid, another member of the amino acid family. Both glutamine and glutamic acid can be found in protein-rich foods such as beans, red meat, nuts and fish. The body uses glutamine to improve mental function, control blood sugar levels and maintain muscle mass, among other applications.

How is it Made?
Glutamine is synthesized by the enzyme glutamine synthetase from glutamate and ammonia. The most relevant glutamine-producing tissue is the muscle mass, accounting for about 90% of all glutamine synthesized. Glutamine is also released, in small amounts, by the lung and the brain. Although the liver is capable of relevant glutamine synthesis, its role in glutamine metabolism is more regulatory than producing, since the liver takes up large amounts of glutamine derived from the gut.

Where is it Found?
Glutamine is found in many foods high in protein, such as fish, meat, beans, and dairy products.

See L-Glutamine related videos:
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Importance of Glutamine
L-GLUTAMINE Benefits
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Benefits / Uses


arw Soreness and swelling inside the mouth, caused by chemotherapy treatments for cancer. Glutamine doesn't seem to reduce pain and swelling for all chemotherapy patients, and it's not clear which patients are likely to benefit. Some researchers suspect that patients who don't have enough glutamine to start with are most likely to be helped.


arw Improving well-being in people with traumatic injuries, when included in a formula used for nutrition. There is some evidence that glutamine keeps bacteria from moving out of the intestine and infecting other parts of the body after major injuries.


arw Treating weight loss and intestinal problems in people with HIV disease (AIDS). Taking glutamine by mouth seems to help HIV/AIDS patients absorb food better and gain weight. Doses of 40 grams per day seem to produce the best effect.
 

Dosage
Take glutamine with cold or room temperature foods or liquids. It should not be added to hot beverages because heat destroys glutamine.

Pediatric:
For children 10 years and younger: Do not give glutamine to a child unless your doctor recommends it as part of a complete amino acid supplement.
For children 10 - 18 years: Doses of 500 mg, 1 - 3 times daily, are generally considered safe.


Adults:
For adults ages 18 and older: Doses of 500, 1 - 3 times daily, are generally considered safe. Doses as high as 5,000 - 15,000 mg daily (in divided doses) may be prescribed by a health care provider.
As an oral rinse for radiation therapy-induced mucositis and chemotherapy-induced stomatitis:
Place 16 gm (one tablespoonful) of glutamine powder in 240 ml (8 ounces) normal saline or sterile water and mix. Then, swish 30 - 60 ml (1 - 2 ounces) and spit out, 4 times a day.

Possible Side-Effects / Precautions / Possible Interactions
Glutamine is possibly safe for most adults and children when taken by mouth, but the potential side-effects of glutamine are not known. Adults should avoid using more than 40 grams of glutamine daily. Children, age 3 to 18, should not be given doses that are larger than 0.65 grams per kg of weight per day. Not enough is known about the safety of higher doses in children.

Special Precautions & Warnings:
Pregnancy and breast-feeding: Not enough is known about the use of glutamine during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Severe liver disease with difficulty thinking or confusion (hepatic encephalopathy): Glutamine could make this condition worse. Avoid use.
Monosodium glutamate (MSG) sensitivity (also known as "Chinese restaurant syndrome"): If you are sensitive to MSG, you might also be sensitive to glutamine, because the body converts glutamine to glutamate.
Mania, a mental disorder: Glutamine might cause some mental changes in people with mania. Avoid use.
Seizures: There is some concern that glutamine might increase the likelihood of seizures in some people. Avoid use.

Possible Interactions



arw Lactulose interacts with glutamine.


arw Lactulose helps decrease ammonia in the body. Glutamine is changed into ammonia in the body. Taking glutamine along with lactulose might decrease the effectiveness of lactulose.


arw Medications for cancer (Chemotherapy) interacts with glutamine.


arw There is some concern that glutamine might decrease the effectiveness of some medications for cancer. But it is too soon to know if this interaction occurs.


arw Medications used to prevent seizures (Anticonvulsants) interacts with glutamine.


arw Medications used to prevent seizures affect chemicals in the brain. Glutamine may also affect chemicals in the brain. By affecting chemicals in the brain, glutamine may decrease the effectiveness of medications used to prevent seizures.
Some medications used to prevent seizures include phenobarbital, primidone, valproic acid, gabapentin, carbamazepine, phenytoin, and others.
 
Research Studies / References
arw Abcouwer SF. The effects of glutamine on immune cells [editorial]. Nutrition. 2000;16(1):67-69.


arw Akobeng AK, Miller V, Stanton J, Elbadri AM, Thomas AG. Double-blind randomized controlled trial of glutamine-enriched polymeric diet in the treatment of active Crohn's disease. J Pediatr Gastroenterol Nutr. 2000;30(1):78-84.


arw Antoon AY, Donovan DK. Burn Injuries. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. Philadelphia, Pa: W.B. Saunders Company; 2000:287-294.


arw Avenell A. Symposium 4: Hot topics in parenteral nutrition Current evidence and ongoing trials on the use of glutamine in critically-ill patients and patients undergoing surgery. Proc Nutr Soc. 2009 Jun 3:1-8. [Epub ahead of print]


arw Buchman AL. Glutamine: commercially essential or conditionally essential? A critical appraisal of the human data. Am J Clin Nutr. 2001;74(1):25-32.


arw Clark RH, Feleke G, Din M, et al. Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy-beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind placebo-controlled study. JPEN: J Parenter Enteral Nutr. 2000;24(3):133-139.


arw Daniele B, Perrone F, Gallo C, et al. Oral glutamine in the prevention of fluorourcil induced intestinal toxicity: a double blind, placebo controlled, randomized trial. Gut. 2001;48:28-33.


arw Decker GM. Glutamine: indicated in cancer care? Clin J Oncol Nurs. 2002;6(2):112-115.


arw Fan YP, Yu JC, Kang WM, Zhang Q. Effects of glutamine supplementation on patients undergoing abdominal surgery. Chin Med Sci J. 2009 Mar;24(1):55-9.


arw Field CJ, Johnson IR, Schley PD. Nutrients and their role in host resistance to infection. J Leukoc Biol. 2002 Jan;71(1):16-32.


arw Furukawa S. Saito H, Inoue T, et al. Supplemental glutamine augments phagocytosis and reactive oxygen intermediate production by neutrophils and monocytes from postoperative patients in vitro. Nutrition. 2000;1695):323-329.


arw Garlick PJ. Assessment of the safety of glutamine and other amino acids.J Nutr. 2001 Sep;131(9 Suppl):2556S-61S. [Review].


arw Greenlee H, Hershman DL, Jacobson JS. Use of antioxidant supplements during breast cancer treatment: a comprehensive review. Breast Cancer Res Treat. 2009 Jun;115(3):437-52. Epub 2008 Oct 7.


arw Grimm H, Kraus A. Immunonutrition--supplementary amino acids and fatty acids ameliorate immune deficiency in critically ill patients. Langenbecks Arch Surg. 2001 Aug;386(5):369-376.


arw Lecleire S, Hassan A, Marion-Letellier R, Antonietti M, Savoye G, et al. Combined glutamine and arginine decrease proinflammatory cytokine production by biopsies from Crohn's patients in association with changes in nuclear factor-kappaB and p38 mitogen-activated protein kinase pathways. J Nutr. 2008 Dec;138(12):2481-6.


arw Medina MA. Glutamine and cancer. J Nutr. 2001;131(9 Suppl):2539S-2542S; discussion 2550S-2551S.


arw Murray SM, Pindoria S. Nutrition support for bone marrow transplant patients. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD002920. Review.


arw Neu J, DeMarco V, Li N. Glutamine: clinical applications and mechanism of action. Curr Opin Clin Nutr Metab Care. 2002;5(1):69-75
arw Reeds PJ, Burrin DG. Glutamine and the bowel. J Nutr. 2001;131(9 Suppl):2505S-8S.


arw Vahdat L, Papadopoulos K, Lange D, et al. Reduction of paclitaxel-induced peripheral neuropathy with glutamine. Clin Cancer Res. 2001;7(5):1192-1197.


arw van Stijn MF, Ligthart-Melis GC, Boelens PG, Scheffer PG, Teerlink T, et al. Antioxidant enriched enteral nutrition and oxidative stress after major gastrointestinal tract surgery. World J Gastroenterol. 2008 Dec 7;14(45):6960-9.


arw Wilmore DW. The effect of glutamine supplementation in patients following elective surgery and accidental injury. [Review]. J Nutr. 2001;131(9 Suppl):2543S-9S; discussion 2550S-1S.


arw Ziegler TR. Glutamine supplementation in cancer patients receiving bone marrow transplantation and high dose chemotherapy. [Review]. J Nutr. 2001;131(9 Suppl):2578S-84S; discussion 2590S.