Glutamine

Other Name(s):

Acide Glutamique, Acide Glutamique HCl, Acide L-(+)-2-Aminoglutaramique, Acide L-Glutamique, Acide L-Glutamique HCl, Alanyl-L-Glutamine Dipeptide, Éthyle Ester de Glutamine, Éthyle Ester de Glutamine HCl, GLN, Glutamate, Glutamic Acid, Glutamic Acid HCl, Glutamina, Glutaminate, Glutamine Ethyl Ester, Glutamine Ethyl Ester HCl, Glutamine Methyl Ester, Glutamine Peptides, Levoglutamide, Levoglutamine, L-(+)-2-Aminoglutaramic Acid, L-Alanyl-L-Glutamine, L-Glutamic Acid, L-Glutamic Acid HCl, L-Glutamic Acid Hydrochloride, L-Glutamic Acid 5-Amide, L-Glutamine, N-Acetyl-L-Glutamine, Peptides de Glutamine, Q, (S)-2,5-Diamino-5-oxopentanoic Acid.

Overview

Glutamine is an amino acid (a building block for proteins), found naturally in the body.

Glutamine is taken by mouth to counter some of the side effects of medical treatments. For example, it is used for side effects of cancer chemotherapy or HIV treatment including diarrhea. It is also used to reduce other side effects of cancer chemotherapy such as nerve pain, swelling inside the mouth (mucositis), loss of some white blood cells, and muscle and joint pains caused by the cancer drug Taxol. Glutamine is also used to protect the immune system and digestive system in people undergoing radiochemotherapy for cancer of the esophagus. Additionally, glutamine is used for improving recovery after bone marrow transplant or bowel surgery, increasing well-being in people who have suffered traumatic injuries, and preventing infections in critically ill people or people following burns.

Some people take glutamine by mouth for digestive system conditions such as diarrhea, inflammation of the pancreas, stomach ulcers, ulcerative colitis, and Crohn's disease, and in people with problems absorbing nutrients because they have HIV or had part of their intestines removed. It is also used for depression, moodiness, irritability, anxiety, insomnia, weight loss, and enhancing exercise performance.

People who have HIV (AIDS) sometimes take glutamine by mouth to prevent weight loss (HIV wasting). It is also used to promote muscle strength in people with cystic fibrosis or muscular dystrophy.

Glutamine is also used for attention deficit-hyperactivity disorder (ADHD), a urinary condition called cystinuria, sickle cell anemia, and for alcohol withdrawal support. In premature or very small newborns, glutamine is used to prevent death or illness.

Glutamine is given intravenously (by IV) for improving recovery after bone marrow transplant, surgery or burns. It is also used to prevent side effects of cancer chemotherapy such as pain and swelling inside the mouth (mucositis) and for preventing infections in critically ill people. In very small newborns, glutamine is used to prevent death or illness.

Glutamine powder can be ordered through most wholesale drug suppliers. Glutamine for commercial use is made by a fermentation process using bacteria that produce glutamine.

How does work?

Glutamine is the most abundant free amino acid in the body. Amino acids are the building blocks of protein. Glutamine is produced in the muscles and is distributed by the blood to the organs that need it. Glutamine might help gut function, the immune system, and other essential processes in the body, especially in times of stress. It is also important for providing "fuel" (nitrogen and carbon) to many different cells in the body. Glutamine is needed to make other chemicals in the body such as other amino acids and glucose (sugar).

After surgery or traumatic injury, nitrogen is necessary to repair the wounds and keep the vital organs functioning. About one third of this nitrogen comes from glutamine.

If the body uses more glutamine than the muscles can make (i.e., during times of stress), muscle wasting can occur. This can occur in people with HIV/AIDS. Taking glutamine supplements might keep the glutamine stores up.

Some types of chemotherapy can reduce the levels of glutamine in the body. Glutamine treatment is thought to help prevent chemotherapy-related damage by maintaining the life of the affected tissues.

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Uses

Possibly Effective for...

  • Burns. Administering glutamine through a feeding tube seems to reduce infections, shorten hospital stays, and improve wound healing in people with severe burns but no lung injury. Administering glutamine through a feeding tube also seems to shorten hospital stays and reduce the risk of infections in people with severe burns and lung injury. Administering glutamine intravenously (by IV) seems to decrease the risk of some infections in people with severe burns. But it does not seem to decrease the risk of death.
  • Critical illness (trauma). Although not all results are consistent, most research shows that glutamine keeps bacteria from moving out of the intestine and infecting other parts of the body after major injuries. Glutamine might also reduce the risk of hospital-acquired infections in people who are critically ill. Glutamine seems to prevent hospital-acquired infections better when given intravenously (by IV) rather than by a feeding tube. Overall, glutamine does not seem to reduce the risk of death in critically ill people.
  • Treating weight loss and intestinal problems in people with HIV/AIDs disease. Taking glutamine by mouth seems to help HIV/AIDS patients absorb food better and gain weight. Doses of 40 grams per day seem to produce the best effect.
  • Surgery. Giving glutamine intravenously (by IV) along with intravenous nutrition seems to improve immune function and reduce complications related to infections after surgery, especially major abdominal surgery. Giving glutamine by IV along with intravenous nutrition might also reduce the risk of infection and improve recovery after bone marrow transplants. However, not all people who receive bone marrow transplants seem to benefit. It's possible that glutamine works best in people receiving bone marrow transplants for blood tissue cancers but not solid tumors.

Possibly Ineffective for...

  • Athletic performance. Taking glutamine by mouth does not seem to improve athletic performance.
  • Crohn's disease. Taking glutamine by mouth does not seem to improve symptoms of Crohn's disease.
  • Inherited disease that causes stones in the kidneys or bladder (Cystinuria). Taking glutamine by mouth does not seem to improve an inherited condition that causes stones to form in the kidneys or bladder.
  • Early infant death. When glutamine is given to preterm infants by needle or in to the gut, illness and early death does not appear to be prevented.
  • Muscular dystrophy. Research shows that taking glutamine by mouth does not improve muscle strength in children with muscular dystrophy.

Insufficient Evidence to Rate Effectiveness for...

  • Diarrhea caused by drugs used to treat HIV. Early research shows that taking glutamine by mouth reduces the severity of diarrhea in people with HIV who are taking the drug nelfinavir.
  • Diarrhea caused by chemotherapy treatments. Some early research shows that glutamine helps prevent diarrhea after chemotherapy. But not all research findings agree.
  • Reducing damage to the immune system during cancer treatment. There is some evidence that glutamine reduces damage to the immune system caused by chemotherapy. However, not all research findings agree.
  • Cystic fibrosis. Early research shows that taking glutamine by mouth does not increase protein gain in children with cystic fibrosis.
  • Diarrhea. One early study shows that taking glutamine by mouth reduces the duration of diarrhea in children. But taking glutamine by mouth along with conventional rehydration solutions does not appear to have an advantage over rehydration solutions alone.
  • Low birth weight. Some research suggests that using glutamine in feeding tubes decreases infections in some low birth weight infants. However, most research suggests that it does not decrease infections, increase growth, decrease the length of hospital stay, or reduce death in low birth weight infants.
  • Obesity. Early research shows that taking glutamine might help with weight loss in obese women.
  • Soreness and swelling inside the mouth, caused by chemotherapy treatments. In some people, taking glutamine by mouth seems to reduce soreness and swelling inside the mouth caused by chemotherapy. But it doesn't seem to benefit all chemotherapy patients. Some researchers think it works best in people with low glutamine levels during chemotherapy treatment.
  • Muscle and joint pains caused by the drug paclitaxel (Taxol, used to treat cancer). There is some evidence that glutamine might help to reduce muscle and joint pains caused by paclitaxel.
  • Inflammation of the pancreas (pancreatitis). An early study shows that giving glutamine intravenously (by IV) along with intravenous nutrition improves immune function but does not reduce the risk for complications or the amount of time spent in the hospital in people with pancreatitis.
  • Nutrition problems after major gut surgery (short bowel syndrome). Researchers have studied whether glutamine combined with growth hormone is effective in treating short bowel syndrome. This combination seems to help some patients become less dependent on tube feeding. However, glutamine alone does not seem to be effective.
  • Anxiety.
  • Attention deficit-hyperactivity disorder (ADHD).
  • Depression.
  • Insomnia.
  • Irritability.
  • Moodiness.
  • Sickle cell anemia.
  • Stomach ulcers.
  • Treating alcoholism.
  • Ulcerative colitis.
  • Other conditions.
More evidence is needed to rate glutamine for these uses.

Side Effects

Glutamine is POSSIBLY SAFE for most adults when taken by mouth in doses up to 40 grams daily, and when used intravenously (by IV) in doses up to 600 milligrams per kilogram of weight daily.

Precautions

Children: Glutamine is POSSBILY SAFE when taken by mouth appropriately. Children aged 3 to 18 years should not be given doses that are larger than 0.7 grams per kg of weight daily. Not enough information is known about the safety of higher doses in children. Glutamine is also POSSIBLY SAFE for children when used intravenously (by IV) in doses up to 400 milligrams per kilogram of weight daily.

Pregnancy and breast-feeding: Not enough is known about the use of glutamine during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Bone marrow transplants: Giving glutamine intravenously (by IV) might increase the risk of mouth ulcers or death in people receiving bone marrow transplant. Until more is known, avoid giving glutamine by IV to these patients. Swishing glutamine in the mouth and then swallowing might be beneficial for these patients.

Cirrhosis: Glutamine could make this condition worse. People with this condition should avoid glutamine supplements.

Severe liver disease with difficulty thinking or confusion (hepatic encephalopathy): Glutamine could make this condition worse. Do not use it.

Mania, a mental disorder: Glutamine might cause some mental changes in people with mania. Avoid use.

Monosodium glutamate (MSG) sensitivity (also known as "Chinese restaurant syndrome"): If you are sensitive to MSG, you might also be sensitive to glutamine, because the body converts glutamine to glutamate.

Seizures: There is some concern that glutamine might increase the likelihood of seizures in some people. Avoid use.

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Interactions


LactuloseInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Lactulose helps decrease ammonia in the body. Glutamine is changed into ammonia in the body. Taking glutamine along with lactulose might decrease the effectiveness of lactulose.


Medications for cancer (Chemotherapy)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

There is some concern that glutamine might decrease the effectiveness of some medications for cancer (chemotherapy). But it is too soon to know if this interaction occurs.


Medications used to prevent seizures (Anticonvulsants)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Medications used to prevent seizures affect chemicals in the brain. Glutamine may also affect chemicals in the brain. By affecting chemicals in the brain, glutamine may decrease the effectiveness of medications used to prevent seizures.

Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.

Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For burns: 0.35-0.5 grams per kilogram body weight each day or 4.3 grams every four hours.
  • For critical illness or trauma: Glutamine has been given in a liquid feed at 0.2-0.6 grams per kilogram body weight each day or at a dose of 20 grams per day has been used. It is usually given for at least 5 days.
  • For HIV wasting: 14-40 grams of glutamine per day has been used in combination with other nutrients.
BY NEEDLE: BY MOUTH:
  • For burns: 0.57 grams of glutamine per kilogram body weight each day has been used for 30 days.
  • For critical illness or trauma: 0.3-0.5 grams per kilogram or 18-21 grams of glutamine compounds have been given daily, sometimes with hormones.
  • For reducing complications after surgery: 0.57 grams of glutamine per kilogram body weight has been used after bone marrow transplantation. Also, 20 grams of glutamine per day or 0.3 grams per kilogram body weight has been used in people undergoing surgery. Sometimes glutamine is given in the form of glutamine dipeptide. Typically 18-30 grams of glutamine dipeptide used. This amount is equivalent to 13-20 grams of glutamine.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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References

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Iwashita, S., Williams, P., Jabbour, K., Ueda, T., Kobayashi, H., Baier, S., and Flakoll, P. J. Impact of glutamine supplementation on glucose homeostasis during and after exercise. J Appl.Physiol 2005;99(5):1858-1865. View abstract.

Jacobi, C. A., Ordemann, J., Zuckermann, H., Docke, W., Volk, H. D., and Muller, J. M. [Effect of alanyl-glutamine in postoperative total parenteral nutrition on postoperative immunosuppression and morbidity. Preliminary results of a prospective randomized study]. Langenbecks Arch.Chir Suppl Kongressbd. 1998;115:605-611. View abstract.

Jacobi, C. A., Ordemann, J., Zuckermann, H., Docke, W., Volk, H. D., and Muller, J. M. [The influence of alanyl-glutamine on immunologic functions and morbidity in postoperative total parenteral nutrition. Preliminary results of a prospective randomized trial]. Zentralbl.Chir 1999;124(3):199-205. View abstract.

Jacobson, S. D., Loprinzi, C. L., Sloan, J. A., Wilke, J. L., Novotny, P. J., Okuno, S. H., Jatoi, A., and Moynihan, T. J. Glutamine does not prevent paclitaxel-associated myalgias and arthralgias. J.Support.Oncol. 2003;1(4):274-278. View abstract.

Juretic, A., Spagnoli, G. C., Horig, H., Babst, R., von, Bremen K., Harder, F., and Heberer, M. Glutamine requirements in the generation of lymphokine-activated killer cells. Clin.Nutr. 1994;13(1):42-49. View abstract.

Kalhan, S. C., Parimi, P. S., Gruca, L. L., and Hanson, R. W. Glutamine supplement with parenteral nutrition decreases whole body proteolysis in low birth weight infants. J Pediatr. 2005;146(5):642-647. View abstract.

Klek, S., Kulig, J., Szczepanik, A. M., Jedrys, J., and Kolodziejczyk, P. The clinical value of parenteral immunonutrition in surgical patients. Acta Chir Belg. 2005;105(2):175-179. View abstract.

Kozelsky, T. F., Meyers, G. E., Sloan, J. A., Shanahan, T. G., Dick, S. J., Moore, R. L., Engeler, G. P., Frank, A. R., McKone, T. K., Urias, R. E., Pilepich, M. V., Novotny, P. J., and Martenson, J. A. Phase III double-blind study of glutamine versus placebo for the prevention of acute diarrhea in patients receiving pelvic radiation therapy. J.Clin.Oncol. 5-1-2003;21(9):1669-1674. View abstract.

Krieger, J. W., Crowe, M., and Blank, S. E. Chronic glutamine supplementation increases nasal but not salivary IgA during 9 days of interval training. J.Appl.Physiol 2004;97(2):585-591. View abstract.

Krzywkowski, K., Petersen, E. W., Ostrowski, K., Kristensen, J. H., Boza, J., and Pedersen, B. K. Effect of glutamine supplementation on exercise-induced changes in lymphocyte function. Am.J.Physiol Cell Physiol 2001;281(4):C1259-C1265. View abstract.

Lacey, J. M., Crouch, J. B., Benfell, K., Ringer, S. A., Wilmore, C. K., Maguire, D., and Wilmore, D. W. The effects of glutamine-supplemented parenteral nutrition in premature infants. JPEN J.Parenter.Enteral Nutr. 1996;20(1):74-80. View abstract.

Lehmkuhl, M., Malone, M., Justice, B., Trone, G., Pistilli, E., Vinci, D., Haff, E. E., Kilgore, J. L., and Haff, G. G. The effects of 8 weeks of creatine monohydrate and glutamine supplementation on body composition and performance measures. J Strength.Cond.Res 2003;17(3):425-438. View abstract.

Lima, A. A., Brito, L. F., Ribeiro, H. B., Martins, M. C., Lustosa, A. P., Rocha, E. M., Lima, N. L., Monte, C. M., and Guerrant, R. L. Intestinal barrier function and weight gain in malnourished children taking glutamine supplemented enteral formula. J Pediatr.Gastroenterol.Nutr. 2005;40(1):28-35. View abstract.

Lin, M. T., Kung, S. P., Yeh, S. L., Liaw, K. Y., Wang, M. Y., Kuo, M. L., Lee, P. H., and Chen, W. J. Glutamine-supplemented total parenteral nutrition attenuates plasma interleukin-6 in surgical patients with lower disease severity. World J Gastroenterol. 10-21-2005;11(39):6197-6201. View abstract.

Lin, M. T., Kung, S. P., Yeh, S. L., Lin, C., Lin, T. H., Chen, K. H., Liaw, K. Y., Lee, P. H., Chang, K. J., and Chen, W. J. The effect of glutamine-supplemented total parenteral nutrition on nitrogen economy depends on severity of diseases in surgical patients. Clin.Nutr. 2002;21(3):213-218. View abstract.

M'bemba, J., Cynober, L., de, Bandt P., Taverna, M., Chevalier, A., Bardin, C., Slama, G., and Selam, J. L. Effects of dipeptide administration on hypoglycaemic counterregulation in type 1 diabetes. Diabetes Metab 2003;29(4 Pt 1):412-417. View abstract.

MacBurney, M., Young, L. S., Ziegler, T. R., and Wilmore, D. W. A cost-evaluation of glutamine-supplemented parenteral nutrition in adult bone marrow transplant patients. J.Am.Diet.Assoc. 1994;94(11):1263-1266. View abstract.

May, P. E., Barber, A., D'Olimpio, J. T., Hourihane, A., and Abumrad, N. N. Reversal of cancer-related wasting using oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine. Am.J.Surg. 2002;183(4):471-479. View abstract.

Mok, E., Eleouet-Da, Violante C., Daubrosse, C., Gottrand, F., Rigal, O., Fontan, J. E., Cuisset, J. M., Guilhot, J., and Hankard, R. Oral glutamine and amino acid supplementation inhibit whole-body protein degradation in children with Duchenne muscular dystrophy. Am.J Clin.Nutr. 2006;83(4):823-828. View abstract.

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Morlion, B. J., Siedhoff, H. P., Joosten, U., Koller, M., Konig, W., Furst, P., and Puchstein, C. [Immunomodulation after parenteral glutamine administration in colorectal surgery]. Langenbecks Arch.Chir Suppl Kongressbd. 1996;113:342-344. View abstract.

Neri, A., Mariani, F., Piccolomini, A., Testa, M., Vuolo, G., and Di Cosmo, L. Glutamine-supplemented total parenteral nutrition in major abdominal surgery. Nutrition 2001;17(11-12):968-969. View abstract.

Neu, J., Roig, J. C., Meetze, W. H., Veerman, M., Carter, C., Millsaps, M., Bowling, D., Dallas, M. J., Sleasman, J., Knight, T., and Auestad, N. Enteral glutamine supplementation for very low birth weight infants decreases morbidity. J.Pediatr. 1997;131(5):691-699. View abstract.

O'Riordain, M. G., De Beaux, A., and Fearon, K. C. Effect of glutamine on immune function in the surgical patient. Nutrition 1996;12(11-12 Suppl):S82-S84. View abstract.

O'Riordain, M. G., Fearon, K. C., Ross, J. A., Rogers, P., Falconer, J. S., Bartolo, D. C., Garden, O. J., and Carter, D. C. Glutamine-supplemented total parenteral nutrition enhances T-lymphocyte response in surgical patients undergoing colorectal resection. Ann.Surg. 1994;220(2):212-221. View abstract.

Ockenga, J., Borchert, K., Rifai, K., Manns, M. P., and Bischoff, S. C. Effect of glutamine-enriched total parenteral nutrition in patients with acute pancreatitis. Clin.Nutr. 2002;21(5):409-416. View abstract.

Peng, X., Yan, H., You, Z., Wang, P., and Wang, S. Clinical and protein metabolic efficacy of glutamine granules-supplemented enteral nutrition in severely burned patients. Burns 2005;31(3):342-346. View abstract.

Peng, X., Yan, H., You, Z., Wang, P., and Wang, S. Effects of enteral supplementation with glutamine granules on intestinal mucosal barrier function in severe burned patients. Burns 2004;30(2):135-139. View abstract.

Peng, X., You, Z. Y., Huang, X. K., Zhang, S. Q., He, G. Z., Xie, W. G., and Quan, Z. F. [Effects of glutamine granules on protein metabolism in trauma patients]. Zhonghua Wai Ke.Za Zhi. 4-7-2004;42(7):406-409. View abstract.

Pertkiewicz, M., Slotwinski, R., Majewska, K., and Szczygiel, B. [Clinical evaluation of amino acid solution]. Pol.Merkur Lekarski. 1999;7(41):211-214. View abstract.

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Piccirillo, N., De Matteis, S., Laurenti, L., Chiusolo, P., Sora, F., Pittiruti, M., Rutella, S., Cicconi, S., Fiorini, A., D'Onofrio, G., Leone, G., and Sica, S. Glutamine-enriched parenteral nutrition after autologous peripheral blood stem cell transplantation: effects on immune reconstitution and mucositis. Haematologica 2003;88(2):192-200. View abstract.

Poindexter, B. B., Ehrenkranz, R. A., Stoll, B. J., Wright, L. L., Poole, W. K., Oh, W., Bauer, C. R., Papile, L. A., Tyson, J. E., Carlo, W. A., Laptook, A. R., Narendran, V., Stevenson, D. K., Fanaroff, A. A., Korones, S. B., Shankaran, S., Finer, N. N., and Lemons, J. A. Parenteral glutamine supplementation does not reduce the risk of mortality or late-onset sepsis in extremely low birth weight infants. Pediatrics 2004;113(5):1209-1215. View abstract.

Powell-Tuck, J. Total parenteral nutrition with glutamine dipeptide shortened hospital stays and improved immune status and nitrogen economy after major abdominal surgery. Gut 1999;44(2):155. View abstract.

Prada, P. O., Hirabara, S. M., de Souza, C. T., Schenka, A. A., Zecchin, H. G., Vassallo, J., Velloso, L. A., Carneiro, E., Carvalheira, J. B., Curi, R., and Saad, M. J. L-glutamine supplementation induces insulin resistance in adipose tissue and improves insulin signalling in liver and muscle of rats with diet-induced obesity. Diabetologia 2007;50(9):1949-1959. View abstract.

Pytlik, R., Benes, P., Patorkova, M., Chocenska, E., Gregora, E., Prochazka, B., and Kozak, T. Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study. Bone Marrow Transplant. 2002;30(12):953-961. View abstract.

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Scheid, C., Hermann, K., Kremer, G., Holsing, A., Heck, G., Fuchs, M., Waldschmidt, D., Herrmann, H. J., Sohngen, D., Diehl, V., and Schwenk, A. Randomized, double-blind, controlled study of glycyl-glutamine-dipeptide in the parenteral nutrition of patients with acute leukemia undergoing intensive chemotherapy. Nutrition 2004;20(3):249-254. View abstract.

Scheltinga, M. R., Young, L. S., Benfell, K., Bye, R. L., Ziegler, T. R., Santos, A. A., Antin, J. H., Schloerb, P. R., and Wilmore, D. W. Glutamine-enriched intravenous feedings attenuate extracellular fluid expansion after a standard stress. Ann.Surg. 1991;214(4):385-393. View abstract.

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Schulman, A. S., Willcutts, K. F., Claridge, J. A., Evans, H. L., Radigan, A. E., O'Donnell, K. B., Camden, J. R., Chong, T. W., McElearney, S. T., Smith, R. L., Gazoni, L. M., Farinholt, H. M., Heuser, C. C., Lowson, S. M., Schirmer, B. D., Young, J. S., and Sawyer, R. G. Does the addition of glutamine to enteral feeds affect patient mortality? Crit Care Med 2005;33(11):2501-2506. View abstract.

Schulman, A. S., Willcutts, K. F., Claridge, J. A., O'Donnell, K. B., Radigan, A. E., Evans, H. L., McElearney, S. T., Hedrick, T. L., Lowson, S. M., Schirmer, B. D., Young, J. S., and Sawyer, R. G. Does enteral glutamine supplementation decrease infectious morbidity? Surg.Infect.(Larchmt.) 2006;7(1):29-35. View abstract.

Sheridan, R. L., Prelack, K., Yu, Y. M., Lydon, M., Petras, L., Young, V. R., and Tompkins, R. G. Short-term enteral glutamine does not enhance protein accretion in burned children: a stable isotope study. Surgery 2004;135(6):671-678. View abstract.

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Stubblefield, M. D., Vahdat, L. T., Balmaceda, C. M., Troxel, A. B., Hesdorffer, C. S., and Gooch, C. L. Glutamine as a neuroprotective agent in high-dose paclitaxel-induced peripheral neuropathy: a clinical and electrophysiologic study. Clin.Oncol.(R.Coll.Radiol.) 2005;17(4):271-276. View abstract.

Suojaranta-Ylinen, R., Ruokonen, E., Pulkki, K., Mertsola, J., and Takala, J. Preoperative glutamine loading does not prevent endotoxemia in cardiac surgery. Acta Anaesthesiol.Scand. 1997;41(3):385-391. View abstract.

Sykorova, A., Horacek, J., Zak, P., Kmonicek, M., Bukac, J., and Maly, J. A randomized, double blind comparative study of prophylactic parenteral nutritional support with or without glutamine in autologous stem cell transplantation for hematological malignancies -- three years' follow-up. Neoplasma 2005;52(6):476-482. View abstract.

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van den Berg, A., van Elburg, R. M., Westerbeek, E. A., Twisk, J. W., and Fetter, W. P. Glutamine-enriched enteral nutrition in very-low-birth-weight infants and effects on feeding tolerance and infectious morbidity: a randomized controlled trial. Am.J Clin.Nutr. 2005;81(6):1397-1404. View abstract.

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