Taking anti-epileptic drugs can cause nutritional deficiencies. There have been studies that have reported the depletion of b vitamins with certain AED’s including phenytoin, carbamazepine, , levetiracetam, lamotrigine, topiramate, specifically b6 deficiency in this study.
Our findings demonstrate that treatment with inducing AEDs commonly causes pyridoxine deficiency, often severe. This could conceivably contribute to the polyneuropathy sometimes attributed to older AEDs, as well as other chronic heath difficulties.
Understanding this, those taking these drugs can ensure that b6 supplementation is taken.
Yet, a carnitine deficiency has also been demonstrated in research for those taking AED’s that include Carbamazapine, valproic acid and phenytoin. The researchers state that they are uncertain if this deficiency occurred prior to the testing, and or prior to the administration of the AED. Still the results from 471 patients are
Total carnitine was reduced by 23% to 48%, free carnitine by 9% to 45%, short-chain fatty acid carnitine by 46% to 64%, and long-chain fatty acid carnitine by 6% to 29%.
Carnitine is critical in energy production. Per Merck Manuals, “Carnitine deficiency results from inadequate intake of or inability to metabolize the amino acid carnitine. It can cause a heterogeneous group of disorders. Muscle metabolism is impaired, causing myopathy, hypoglycemia, or cardiomyopathy. Infants typically present with hypoglycemic, hypoketotic encephalopathy.” In my practice I’ve had parents and adults report low energy, fatigue and even malaise. As mentioned carnitine is an amino acid and deficiency can result in varying symptoms.
Unlike B6, carnitine should be cautiously supplemented as it can cause seizures in some, and in particular if a deficiency is not present.
The standard of care, as I understand it, is a medical doctor or neurologist will test carnitine levels if the individual is on a high fat/low carb diet including the ketogenic diet and/or MAD. However, they may not offer to test levels simply due to a prescription for an anti-epileptic drug, specifically Carbamazapine, valproic acid, phenytoin.
Be sure to urge your neurologist to test for carnitine deficiency and consider b vitamin supplementation.
Bringing much light,
Lynn
