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Researchers at the University of Messina reported that supplementation with L-carnitine, a quaternary amine which occurred naturally in the body, could eliminate the side effects of thyroxine treatment and thus reduced the need for constant monitoring.

It is estimated that goiter (enlarged thyroid gland) affects about 200 million people worldwide. It is far more common among women and is almost always the result of an iodine deficiency. It can often be corrected by increasing iodine intake. In some cases it is necessary to dampen the activity of the thyroid-stimulating hormone (TSH) in order to treat the goiter. This is usually done by prescribing thyroid hormone (levothyroxine). Levothyroxine, however, has many adverse effects and also needs constant monitoring to ensure that blood levels are adequate.

Scientists conducted a randomized, double-blind, placebo-controlled, crossover trial involved 50 women who were being treated for benign nodular goiter with levothyroxine. The women were allocated to a placebo group, Group A that received two or four grams of carnitine daily for two months out of the six-month trial period or group B, which received two or four grams carnitine daily for four months.

The researchers measured a number of blood parameters and symptoms in the placebo and treatment groups. They concluded that L-carnitine supplementation significantly reduced thyroxine therapy induced weakness, breathlessness, palpitations, nervousness, insomnia, tremors and elevated heart rate.

Carnitine also increased bone mass (bone mineral density) by about two per cent after just four months of supplementation. In contrast, placebo group members lost bone mass during the trial. The researchers noted that L-carnitine was non-toxic and did not interact with any drugs.

Researchers suggested that L-carnitine supplementation (perhaps as little as one gram/day) could be of clinical use in goiter therapy and in the treatment of other thyrotoxicosis-related disorders such as amiodarone-related thyrotoxicosis, according to the Journal of Clinical Endocrinology & Metabolism (Vol. 86, August, 2001, pp. 3579-94).