L-Carnitine Surprise Benefits in Post Stroke and Creatine for Statin Myopathy

L- Carnitine up to 3 gm/day was used in a post stroke victim with leg pain and wasting.  It attenuated both. CK levels rose when she spotted the L carnitine. In a separate study, creatine 5 gm/day prevented statin myopathy pains.

J Stroke Cerebrovasc Dis. 2018 Sep 1. pii: S1052-3057(18)30426-9. doi:
10.1016/j.jstrokecerebrovasdis.2018.07.033. [Epub ahead of print]
Effects of l-Carnitine Supplementation, Botulinum Neurotoxin Injection, and
Rehabilitation for a Chronic Stroke Patient.
Endo S et al
https://www.ncbi.nlm.nih.gov/pubmed/30181037

• L -carnitine is “essential for free fat acid metabolism in mitochondria”
• purported to help endurance in cancer
• case – 58 year old with hemiplegia
• leg pain and fatigue limited recovery
• Starting with 1.5 gm carnitine and working up to 3 gms
• “After prescription, her leg pain and fatigue during walking disappeared and her continuous walking distance increased rapidly.”
• at one point carnitine was stopped and CPK blood levels doubled – suggesting the carnitine was controlling muscle damage

In separate study:

• 66 yr old with hyperlipidemia
• amaurosis fugax,  with carotid stenosis
• unable to tolerate 5 mg simvastatin due to pains but when reintroduced with creatine – had no problems
• they used 5 gm/day

In one study of cramps induced by hemodialysis, they used creatine monohydrate  12 gm/day and got a 60% reduction in cramps:
Nephrol Dial Transplant. 2002 Nov;17(11):1978-81.
Creatine monohydrate treatment alleviates muscle cramps associated with haemodialysis.
Chang CT et al
https://www.ncbi.nlm.nih.gov/pubmed/12401856

The use of conenzyme q10 is equivocal:
In:
Zaleski, Amanda L., Beth A. Taylor, and Paul D. Thompson. “Coenzyme Q10 as Treatment for Statin-Associated Muscle Symptoms—A Good Idea, but….” Advances in Nutrition 9.4 (2018): 519S-523S.
https://academic.oup.com/advances/article-abstract/9/4/519S/5055942

• “Estimates of SAMS incidence vary from <1% in industry-funded clinical trials to 10–25% in nonindustry-funded clinical trials and ∼60% in some observational studies.”
• I have never seen much help from Coenzyme q10.
• Using Vitamin D helped but I suspect  more in those with lower blood levels

Comment – the use of carnitine in post stroke cases would be useful and I know one case I might want to try it on. The use of creatine in statin myopathy is big I took high does statins myself until I found I was using my hands to get out of a chair – stopped the meds and recovered – only to find it re-happened on trying it again. If it could help with my pain cases it would be a major plus.