L-Glutamine Dosage Guide: Protocols, Calculator & Safety

Dosage for L-Glutamine varies by protocol. Consult a qualified healthcare provider.

Administration frequency depends on the specific protocol. Consult current research literature.

Cycling requirements depend on the protocol. Follow established research guidelines.

## Prescription use in sickle cell disease In the two placebo-controlled trials behind the Endari approval (187 patients on Endari, 111 on placebo), the adverse reactions seen in more than 10 percent of patients on Endari were constipation (21 versus 18 percent on placebo), nausea (19 versus 14 percent), headache (18 versus 15 percent), abdominal pain (17 versus 16 percent), cough (16 versus 14 percent), pain in the arms or legs (13 versus 7 percent), back pain (12 versus 5 percent) and chest pain (12 versus 8 percent); 2.7 percent stopped treatment because of an adverse reaction, and three deaths occurred on Endari against none on placebo, none judged related to treatment (Endari FDA label). The phase 3 trial reported low-grade nausea, noncardiac chest pain, fatigue and musculoskeletal pain more often with glutamine than with placebo (PMID: 30021096). ## Critical illness In the REDOXS trial of 1,223 ventilated patients with multiorgan failure, glutamine given intravenously and enterally was linked to a trend toward higher 28-day mortality and to significantly higher in-hospital and 6-month mortality (PMID: 23594003). A post hoc analysis found the greatest potential for harm in patients who already had kidney dysfunction at enrollment (PMID: 24803474). In the MetaPlus trial, a tube-feeding formula enriched with glutamine and other nutrients was linked to higher 6-month mortality in medical patients (PMID: 25096691). Other large trials found no difference in mortality (PMID: 21415104; PMID: 36082909), and the burns trial found no substantial difference in serious adverse events (PMID: 36082909). ## Oral use in other trials In the post-infectious IBS trial, adverse events and study-drug discontinuation were low and similar with glutamine and placebo, with no serious adverse events (PMID: 30108163), and the low FODMAP add-on trial reported no serious adverse events (PMID: 34977110). Early studies in healthy volunteers found no clinical toxicity and no rise in ammonia or glutamate after oral glutamine loads or glutamine-enriched intravenous nutrition (PMID: 2119459; PMID: 2122714). In a small trial of glutamine-supplemented intravenous nutrition in adults with inflammatory bowel disease, three central catheter infections occurred in the glutamine group and none in the control group, a difference that was not statistically significant (risk ratio 7.00, 95 percent confidence interval 0.40 to 122.44) (PMID: 26853855). ## Liver disease In people with liver cirrhosis, a 20 g oral glutamine load roughly doubled arterial ammonia, which did not happen in healthy controls (PMID: 24078984).

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