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Carnitine levels and the ketogenic diet
E Berry-Kravis1, G Booth, A C Sanchez
1Department of Pediatrics, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA. Elizabeth_M_Berry-Kravis@rush.edu
Epilepsia
|March 7, 2002
Summary
The ketogenic diet (KD) may lower carnitine levels initially, but long-term treatment stabilizes levels. Carnitine depletion is uncommon and rarely causes complications in patients on the ketogenic diet.
Area of Science:
- Biochemistry
- Nutrition
- Neurology
Background:
- The ketogenic diet (KD) is an effective therapy for refractory epilepsy.
- Carnitine plays a vital role in fatty acid metabolism.
- Concerns exist regarding potential carnitine depletion with KD therapy.
Purpose of the Study:
- To investigate the long-term effects of the ketogenic diet on carnitine levels.
- To determine if carnitine depletion is a significant cause of complications during KD initiation and treatment.
Main Methods:
- Prospective analysis of carnitine levels at multiple time points (0, 1, 6, 12, 24 months) in 38 patients initiating KD.
- Correlation of carnitine levels with antiepileptic drug (AED) history, blood glucose, and time to ketosis.
- Analysis of clinical complications and need for carnitine supplementation.
Main Results:
- Total carnitine (TC) levels at initiation negatively correlated with the number of concurrent AEDs.
- TC decreased in early KD treatment but stabilized or increased with long-term therapy.
- No patients exhibited clinical signs of carnitine deficiency, and only 19% received supplementation.
Conclusions:
- Multiple AEDs, not KD initiation, are associated with lower TC.
- Significant carnitine deficiency is uncommon in patients starting KD.
- TC levels do not predict hypoglycemia or difficulties achieving ketosis; supplementation is generally not required.