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L-Glutamine

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Specifically for Chronic Pancreatitis

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Why it works for Chronic Pancreatitis:

Biology & rationale (general): Glutamine is a major fuel for enterocytes and immune cells and is a precursor for glutathione, so it can support gut-barrier integrity and antioxidant defenses. These mechanisms are relevant to pancreatitis in general because gut barrier dysfunction and oxidative stress can occur—especially in acute severe disease. espen.org

But for chronic pancreatitis specifically: Authoritative guidelines and reviews on CP management do not recommend glutamine as a treatment (for pain, maldigestion, or disease modification). Management focuses on nutrition assessment, pancreatic enzyme replacement therapy (PERT) for exocrine pancreatic insufficiency, analgesia, risk-factor modification (no alcohol, stop smoking), and treating complications. espen.org

How to use for Chronic Pancreatitis:

  • In pancreatitis, the only setting where glutamine shows a role is selected patients with severe acute pancreatitis (AP) who require parenteral nutrition (PN). ESPEN’s practical guidance: when EN isn’t feasible and PN is indicated, add parenteral L-glutamine at ~0.20 g/kg/day; otherwise there is no role for immunonutrition (including glutamine). This is not a recommendation for chronic pancreatitis or for routine oral supplements. 2022.espen.org
  • Meta-analyses in acute pancreatitis suggest any benefit, when seen, was mainly with parenteral glutamine alongside PN—not with enteral/oral feeding. ScienceDirect

For chronic pancreatitis, there are no guideline-endorsed dosing instructions for L-glutamine (oral or otherwise), because it isn’t recommended as a treatment. If you’re considering it despite this, discuss it with your gastroenterologist to avoid interactions with your individualized nutrition/PERT plan. espen.org

Scientific Evidence for Chronic Pancreatitis:

Acute pancreatitis (context only):

  • RCT/meta-analysis signals of benefit for parenteral (IV/PN) glutamine in severe AP (reductions in complications/LOS), with no benefit for enteral glutamine. ScienceDirect
  • ESPEN practical guideline distills this to a narrow recommendation: add 0.20 g/kg/day L-glutamine only when PN is indicated; otherwise, no role for immunonutrition. 2022.espen.org
Specific Warnings for Chronic Pancreatitis:

Critical-illness caution: In the REDOXS ICU trial (not pancreatitis-specific), early high-dose glutamine in patients with multiorgan failure increased mortality—a reminder that glutamine isn’t benign in all settings and high doses/early use can be harmful in very sick patients. New England Journal of Medicine

Liver and renal disease: Because glutamine is metabolized to ammonia, many references caution against use in significant hepatic dysfunction (risk of hyperammonemia/encephalopathy) and in severe renal impairment; discuss with your clinician if you have these conditions. (General drug-info sources and reviews.) MedlinePlus

Drug interactions & side effects: Formal interaction potential is limited but not zero; check for interactions and report all meds/supplements to your clinician/pharmacist. Common adverse effects can include GI upset. (General monographs.) 

General Information (All Ailments)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

What It Is

L-Citrulline is a non-essential amino acid, meaning the body can produce it naturally. It was first identified in watermelon (Citrullus vulgaris), which is where it gets its name. Unlike essential amino acids, L-citrulline isn’t directly incorporated into proteins. Instead, it serves as a precursor to other important compounds, most notably L-arginine and nitric oxide (NO), both of which play significant roles in cardiovascular and muscular health.

It can be found naturally in foods such as watermelon, cucumbers, and pumpkins, and it’s also available as a dietary supplement—either in pure form or as L-citrulline malate (a combination of citrulline and malic acid, often used to enhance exercise performance).

How It Works

L-Citrulline functions mainly through its conversion into L-arginine in the kidneys. L-arginine then serves as a substrate for the enzyme nitric oxide synthase (NOS), which generates nitric oxide (NO)—a critical molecule for vasodilation (the widening of blood vessels).

By increasing nitric oxide levels, L-citrulline can help improve blood flow, oxygen delivery, and nutrient transport to tissues. This mechanism has several downstream effects:

  1. Improved Exercise Performance: Enhanced blood flow delivers more oxygen and nutrients to working muscles, potentially reducing fatigue and improving endurance.
  2. Cardiovascular Health: Better endothelial (blood vessel) function may help reduce blood pressure and support overall heart health.
  3. Enhanced Recovery: Increased circulation may assist in clearing metabolic waste (like ammonia and lactic acid) from muscles after intense exercise.
  4. Erectile Function: Improved nitric oxide availability can aid in relaxing blood vessels, a mechanism similar to that of erectile dysfunction medications.

An additional pathway involves ammonia clearance. L-citrulline plays a role in the urea cycle, which helps the body eliminate ammonia, a toxic byproduct of protein metabolism. This contributes to improved recovery and reduced muscle fatigue.

Why It’s Important

L-Citrulline’s importance lies in its broad range of physiological benefits, especially for vascular, muscular, and metabolic health:

  • Supports Cardiovascular Function: Through nitric oxide production, it helps maintain healthy blood pressure and vessel elasticity.
  • Enhances Exercise Performance: Studies show it may delay fatigue, improve endurance, and increase strength output, particularly in resistance training and high-intensity workouts.
  • Promotes Muscle Recovery: Its role in ammonia detoxification and improved blood flow helps accelerate recovery between training sessions.
  • May Aid Sexual Health: Because it enhances circulation, L-citrulline has been researched as a natural aid for mild erectile dysfunction.
  • Supports General Energy Metabolism: The malate component in citrulline malate contributes to the Krebs cycle (the body’s primary energy production pathway), potentially improving overall energy availability.

Considerations

While L-citrulline is generally considered safe and well-tolerated, there are several points to consider before use:

Dosage:

  • Typical doses range from 3 to 6 grams per day for general circulatory or cardiovascular support.
  • For exercise performance, studies often use 6 to 8 grams of L-citrulline malate taken 30–60 minutes before training.

Possible Side Effects:

  • Most people experience no adverse effects, but mild gastrointestinal discomfort (bloating or nausea) can occur at higher doses.
  • Because it can lower blood pressure, individuals already on antihypertensive medications should consult a healthcare professional.

Interactions:

  • Combining L-citrulline with other nitric oxide boosters (like L-arginine or beetroot extract) may enhance its effects—but also potentially lower blood pressure more than desired.
  • Those taking nitrate medications (e.g., for heart disease) should use caution.

Form and Purity:

  • L-Citrulline Malate is often preferred for performance purposes due to better absorption and synergistic energy benefits.
  • Always select third-party tested supplements to ensure purity and correct dosing.

Long-Term Use:

  • Research supports its safety in both short- and medium-term use (up to 12 months), but long-term studies are still limited.
  • Its effects may vary between individuals depending on diet, fitness level, and baseline nitric oxide status.

Helps with these conditions

L-Glutamine is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.

Leaky Gut Syndrome 0% effective
Food Allergies 0% effective
Chronic Pancreatitis 0% effective
3
Conditions
0
Total Votes
16
Studies
0%
Avg. Effectiveness

Detailed Information by Condition

Primary fuel for enterocytes (intestinal lining cells). Enterocytes use glutamine as a preferred energy source; supplying extra glutamine helps epithe...

0 votes Updated 2 months ago 6 studies cited

Food Allergies

0% effective

There is plausible mechanistic and some clinical evidence that glutamine helps intestinal barrier/immune function (which could reduce antigen exposure...

0 votes Updated 2 months ago 8 studies cited

Biology & rationale (general): Glutamine is a major fuel for enterocytes and immune cells and is a precursor for glutathione, so it can support gu...

0 votes Updated 1 month ago 2 studies cited

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