A new study confirmed that depression and chronic fatigue often occur in multiple sclerosis (MS); and in a related condition known as neuromyelitis optica (NMO). NMO is similar to MS because myelin–the fatty substance that insulates nerve cells and helps them to communicate–is also lost. In NMO the myelin deteriorates mostly in the optic nerve, which can lead to blindness, and in the spinal cord. In MS myelin can be lost throughout the nervous system.
Anyone who has MS knows that depression and chronic fatigue commonly go along with the disease. Although having a chronic medical condition can certainly worsen mood, the loss of myelin in the nervous system may also contribute to depression and loss of energy. Some scientists believe that low carnitine levels in the blood could cause depression and fatigue, possibly even due to the use of medications. Carnitine helps to transport essential nutrients to muscle cells, so lower levels could have a direct effect of energy. One way to increase carnitne could be by giving people the oral supplement acetyl levocarnitine (l-carnitine).
In their study, titled “Depressive state and chronic fatigue in multiple sclerosis and neuromyelitis optica“, published in the Journal of Neuroimmunology, researchers decided to study depression, fatigue and the use of l-carnitine in seventy-five patients with MS and 39 patients with NMO at Tohoku University Hospital in Japan. Tetsuya Akaishi of the Department of Neurology, Tohoku University School of Medicine, Sendai, Japan, led the study. The scientists found that participants more often had severe and not mild levels of depression, in a total of 47 MS patients (62.7%) and 29 NMO patients (74.4%).
The team also studied eleven patients with low carnitine levels (six MS and five NMO patients), who agreed to take l-carnitine at 1800 mg/day for a month. However, the low carnitine levels were not associated with increased depression and fatigue and taking l-carnitine for a month did not improve depression or fatigue in these 11 individuals.
In their report, the researchers concluded ” Carnitine is occasionally low in the sera of MS and NMO, but does not seem to play a major role in depression and fatigue in these diseases. Measurement of the serum carnitine levels and administration of oral l-carnitine seem not to be beneficial.”
The research underscores the importance of assessing emotional symptoms and energy levels in people with diseases associated with myelin loss, including MS and NMO. This is the first study to identify that these problems are also common in people with NMO. Unfortunately, l-carnitine supplements do not seem to be a good treatment for depression and fatigue in the two diseases. Future studies will hopefully focus on more effective treatments.