Glutamine is the most abundant free amino acid in the body. However, its safety reputation was tarnished in 2013, when a large trial involving 1,223 intensive care patients found 32.4% mortality at 28 days in those receiving high doses of glutamine, compared to 27.2% in others. At the same time, a trial in adults with intestinal disorders measured 3.8% adverse effects with 15 g per day—exactly the same as with placebo.
These two results are not contradictory: they involve very different populations, doses, and routes of administration. This guide addresses each risk based on studies identified via PubMed, with its actual frequency and a verdict on four levels: established, rare, theoretical, or misconception.
In healthy adults : at typical doses, glutamine is well tolerated in trials. A safety review identifies 14 g per day as the intake level up to which the absence of adverse effects is solidly documented (this is not a toxicity threshold). Digestive effects do occur but remain rare and mild; at 15 g per day for 8 weeks, they were no more frequent than with placebo.
The real risks concern specific situations: increased mortality in intensive care patients with multiple organ failure receiving very high doses by infusion and feeding tube, especially in case of kidney damage according to exploratory analysis; a clear increase in ammonia in people with cirrhosis; a few isolated cases of kidney, liver, or brain damage. For cancer, the risk remains theoretical. Data are lacking during pregnancy, breastfeeding, and in children.
- Dangerous or not? What safety reviews say
- Digestive troubles: rare and mild at typical doses
- Athletes: doses of 5 to 50 g and beyond
- Sensitive gut: what trials show
- Intensive care: the mortality signal, explained
- The kidneys: one published case and one signal in intensive care
- Liver, ammonia, and encephalopathy
- Glutamine and cancer: laboratory versus clinical trials
- Brain, mood, epilepsy: limited data
- Pregnancy, breastfeeding, children, and seniors
- Interactions, risk table, and safety guidelines
- Frequently asked questions
Dangerous or not? What safety reviews say
The body produces glutamine itself: the real question is to determine from what dose and in whom a supplement may pose problems.
A safety review examined published clinical trials on taurine, glutamine, and arginine. Its authors found no systematic pattern of adverse effects in humans with oral glutamine. They identified the highest intake level for which evidence of no adverse effects is solid: 14 g per day for healthy adults. Significantly higher doses have been tested without adverse effects, but the data are too limited to conclude on their long-term safety.
In healthy volunteers, single oral doses of 0.1 and 0.3 g per kilogram of body weight increased blood glutamine with no signs of clinical toxicity or production of toxic metabolites, ammonia, and glutamate. Added to intravenous nutrition for 5 days, up to 0.570 g per kilogram per day, it was well tolerated, with no clinical or biological abnormalities.
Ziegler TR, Benfell K, Smith RJ, et al. JPEN J Parenter Enteral Nutr 1990;14(4 Suppl):137S-146S. DOI: 10.1177/0148607190014004201
For a 70-kilogram adult, 0.3 g per kilogram represents 21 g at once, according to our calculation. A second study by the same team, in 7 healthy volunteers infused at 0.285 then 0.570 g per kilogram per day, found neither an increase in ammonia nor any mental status abnormalities.
The counterpoint comes from a researcher who devoted two reviews to possible side effects of prolonged consumption. He notes that some people consume approximately 40 g per day and describes possible long-term mechanisms: competition with other amino acids for their transporters, increased ammonia and glutamate production, blood amino acid imbalance, unresolved question of tumor growth, risk of deficiency upon cessation. The author concludes that high intakes have substantial side effects; some changes in blood amino acids have been measured, but most other points remain mechanisms untested in long-term trials. His second review calls for specifically studying seniors, children, pregnancy, breastfeeding, and liver diseases.
Established : observed reproducibly in controlled trials. Rare : described in isolated cases, with a possible but unproven cause-and-effect link. Theoretical : plausible according to physiology or laboratory findings, without demonstration in humans. Misconception : contradicted by available data.
Digestive troubles: rare and mild at typical doses
In 115 adults with irritable bowel syndrome with diarrhea that appeared after intestinal infection, 5 g of glutamine three times per day for 8 weeks led to 3.8% adverse effects, exactly like placebo (a whey protein powder): 1.9% abdominal pain and 1.9% bloating in each group. No serious adverse effects, no neurological effects, no withdrawal effects upon cessation; 8.5% discontinuations under glutamine versus 7.1% under placebo, all voluntary.
Zhou Q, Verne ML, Fields JZ, et al. Gut 2019;68(6):996-1002. DOI: 10.1136/gutjnl-2017-315136
In this trial, adults took 15 g per day, which is three times the daily dose of our L-glutamine powder, which is taken at a rate of one 5 g measuring spoon.
Other trials point in the same direction, as summarized in the table below. The signal is not entirely absent, however: a British team notes that previously validated doses are "not universally well tolerated," and mild nausea appeared more frequently with glutamine in a large 48-week trial.
| Population and dose | Digestive tolerance observed | Study |
|---|---|---|
| 115 randomized adults (106 analyzed), irritable bowel, 15 g per day, 8 weeks | 3.8% adverse effects, similar to placebo | Zhou, 2019 |
| 10 active men, single intake up to 0.9 g per kilogram of lean body mass | Mild symptoms, no difference from placebo | Pugh, 2017 |
| 10 men, single intake of 0.3 g per kilogram of lean body mass | No symptoms of intolerance reported | Ogden, 2022 |
| Patients undergoing radiotherapy, most often 10 g three times per day | No difference from placebo in the 2 trials that measured adverse effects | Shuai, 2020 |
| 230 children and adults with sickle cell disease, 0.3 g per kilogram twice per day, 48 weeks | Mild nausea more frequent than with placebo | Niihara, 2018 |
| 18 children, Crohn's disease, formula enriched with glutamine, 4 weeks | 2 trial withdrawals for intolerance, both in the glutamine group | Akobeng, 2000 |
Mild digestive disorders are possible, especially at high doses. Practical advice, not tested as such: dissolve the powder well in a large glass and divide doses if the stomach is sensitive.
Athletes: doses of 5 to 50 g and more
In a double-blind trial of 31 young adults aged 18 to 24, the dose was 0.9 g per kilogram of lean body mass per day for 6 weeks of strength training, which, according to our calculation, amounted to several dozen grams per day for an adult. The abstract does not describe adverse effect monitoring; it concludes there was no effect on strength and lean mass compared to placebo.
A 2019 meta-analysis pooled 47 studies in adult athletes, of which 25 were statistically combined. It generally finds no effect of glutamine on immunity, aerobic performance, or body composition, with the exception of slightly more marked weight loss, averaging 1.36 kilograms. Our articles on glutamine and muscle recovery and on glutamine in athletes detail what studies show about these uses.
Protocols expressed in grams per kilogram quickly result in high quantities: 0.9 g per kilogram of lean mass represents approximately 54 g in a single dose for a 70-kilogram man according to the team that tested it, well beyond the 14 g per day, the level of intake up to which the absence of adverse effects is solidly documented (this is not a toxicity threshold). Our L-glutamine is taken at 5 g per day, in one measuring spoon or, for athletes, 2.5 g before and 2.5 g after exercise.
No trial in adult athletes reports adverse effects at the studied doses, but tolerance is rarely measured, and the safety of very high doses over months is not established.
Fragile gut: what trials show
Glutamine is a major fuel for cells that line the intestine. In the Gut trial described above, conducted in adults whose intestines became more permeable after an infection, 79.6% of patients on glutamine saw their symptoms decrease by at least 50 points on the irritable bowel severity scale, compared to 5.8% on placebo, and intestinal permeability normalized. The authors call for this result to be confirmed by larger trials.
In active men running in the heat, a single dose reduced intestinal permeability markers by approximately 25% at 0.25 g per kilogram of lean mass and by approximately 40% at 0.9 g, while another team observed no protection with 0.3 g. Our article on glutamine and intestinal permeability covers these trials in detail.
The studies in this section concern glutamine: none of their results can be attributed to Probiomix, whose strains have not been tested in them. It is intended for adults who wish to care for their microbiota with a low FODMAP formula, and is not recommended for children under 6 years, during pregnancy and breastfeeding. Our guide on probiotics: benefits and how to choose details the selection criteria.
In case of inflammatory bowel disease, persistent diarrhea, blood in stools or weight loss, medical evaluation takes priority over any supplement.
Intensive care: the mortality signal, explained
This is the most serious data. The REDOXS trial included adults on mechanical ventilation, admitted to intensive care with failure of at least two organs. Glutamine was given starting in the first 24 hours, continuously, both by infusion, at 0.35 g per kilogram per day, and by feeding tube, 30 g per day in addition, independently of nutrition, for a maximum of 28 days. For a 70-kilogram adult, this represents approximately 55 g of glutamine per day, according to our calculation.
In patients from 40 intensive care units with multiorgan failure, 28-day mortality was 32.4% with glutamine versus 27.2% without, a trend at the limit of significance (adjusted odds ratio of 1.28). Mortality at hospital discharge and at 6 months was significantly higher with glutamine. Glutamine reduced neither organ failures nor infections, and serious adverse effects did not differ between groups.
Heyland D, Muscedere J, Wischmeyer PE, et al. N Engl J Med 2013;368(16):1489-1497. DOI: 10.1056/NEJMoa1212722
A complementary analysis by the same team clarifies the picture. After adjustment for patients' initial status, the excess mortality at 6 months persisted, with a hazard ratio of 1.23. In an exploratory analysis, conducted retrospectively, the excess risk was concentrated in patients who already had renal impairment at baseline; among the 776 patients without renal impairment, no effect, neither favorable nor unfavorable, appeared. The authors hypothesize an accumulation of glutamine or one of its derivatives when kidneys filter poorly. They call for caution before extending these conclusions to lower doses in other patients.
In the MetaPlus trial, conducted in 301 ventilated patients, tube feeding enriched with glutamine, omega-3, selenium and antioxidants did not reduce infections, and 6-month mortality in medical patients reached 54%, compared to 35% with standard nutrition; two of the authors worked for a medical nutrition company, and the mixture does not allow glutamine to be isolated. In 1,200 severely burned patients, 0.5 g of glutamine per kilo per day by tube or orally neither shortened hospitalization nor altered 6-month mortality, 17.2% versus 16.2% under placebo. In patients undergoing surgery in intensive care, a meta-analysis of 7 glutamine infusion trials found fewer infections and shorter hospitalization by 4.09 days, without significant reduction in mortality.
It is established that very high doses of glutamine, given by infusion and tube to patients with multi-organ failure, provide no benefit and are associated with higher mortality; an exploratory analysis suggests that the risk is mainly present in case of renal impairment. The result does not translate directly to 5 g per day by mouth in a healthy person, but it justifies a simple rule: in case of hospitalization for serious illness, one does not take glutamine on one's own initiative, and one should report any glutamine one was taking.
The kidneys: one published case and a signal in intensive care
The kidney uses glutamine to produce ammonia and bicarbonate. Three types of data exist.
In healthy persons, no trial found describes renal impairment at standard doses. Trials often exclude diseased kidneys, however, such as the 15 g per day trial, which excluded persons whose creatinine exceeded 2.5 mg/dL: the absence of signal applies to healthy kidneys.
In intensive care, in an exploratory analysis of the REDOXS trial, the excess mortality risk was concentrated in patients with renal impairment at baseline, as seen above.
A Dutch team describes acute renal failure from damage to kidney tubules in a patient taking 18 g of L-glutamine per day as a supplement. The hypothesis judged most likely by the authors is excessive ammonia production in each filtration unit of the kidney. They recommend cautious use of glutamine supplements in elderly persons whose kidney function is already impaired.
Bhoelan S, Kürül S, Krol CG, et al. Nephron 2025;150(1):47-51. DOI: 10.1159/000548247
This is an isolated case: it does not allow us to know the frequency of this effect or to state with certainty the causal link.
In case of chronic kidney disease, single kidney, dialysis, or after age 65 with decreased kidney function, glutamine as a supplement should only be taken with physician approval. This precaution is moreover noted on our product, advised against in case of kidney disease except on medical advice.
Liver, ammonia and encephalopathy
Glutamine is partly converted to ammonia, a substance the liver neutralizes. When the liver is healthy, it largely absorbs this excess: in tolerance studies in healthy volunteers, blood ammonia did not increase notably, neither after oral doses up to 0.3 g per kilo, nor after prolonged infusion. After 20 g, however, a modest increase was measured in 13 healthy controls (from 52 to 78 µmol/L in one hour). When the liver is diseased, the increase becomes marked.
In 57 persons with cirrhosis but without apparent neurological disorder, an oral dose of 20 g of glutamine increased capillary blood ammonia from 75 to 117 then 169 µmol/L at 30 and 60 minutes, compared to 52, 59 and 78 µmol/L in 13 healthy controls. The proportion of patients with subtle cognitive disorders related to the liver increased from 44% to 67% after one hour. The test was well tolerated, with one case of nausea and one case of dizziness.
Ditisheim S, Giostra E, Burkhard PR, et al. BMC Gastroenterol 2011;11:134. DOI: 10.1186/1471-230X-11-134
This phenomenon is reliable enough to serve as a provocation test in hepatology studies: 10 to 20 g of glutamine are given to unmask early hepatic encephalopathy. In 126 persons with cirrhosis, an abnormal response to 10 g of glutamine associated with these subtle disorders was linked to lower survival. The practical conclusion is clear: in case of cirrhosis, history of hepatic encephalopathy or chronic liver disease, glutamine as a supplement has no place without specialist advice.
Two isolated observations complete the picture. A Swiss team describes ammonia excess encephalopathy in a woman in intensive care, in a state of intense catabolism, who was receiving glutamine; the authors attribute the ammonia excess to both this catabolism and the glutamine provided. Her tests suggested a urea cycle disorder, the pathway that eliminates ammonia, and the condition improved with specific treatment and protein restriction. An Iranian team reports severe acute hepatitis, with jaundice and transaminases at 2,500 IU/L, in a 35-year-old female bodybuilder who had been taking powdered glutamine for three weeks, at a dose reported inconsistently in the article (10 g of powder per day, presented as equivalent to 170 mg of pure glutamine). She occasionally consumed alcohol, which the authors consider may have worsened the condition. Other causes were investigated, but the patient refused biopsy, the presence of contaminants in the powder could not be verified, and the causality score classifies the link as only "possible." She recovered in two weeks after stopping, under supportive treatment.
The increase in ammonia in liver disease is an established and reproducible effect. For liver impairment in healthy persons, our search found only one published case, of possible causality. Jaundice, dark urine or confusion require stopping and consulting a physician.
Glutamine and cancer: laboratory versus clinical trials
The concern is based on a biological reality. A landmark review published in Nature Reviews Cancer reminds us that genetic alterations in cancer cells make them dependent on certain nutrients, including glutamine, to the point that researchers are exploring its use by tumors as a treatment target. A review devoted to glutamine side effects also considers the question unresolved.
Data in patients, however, point in another direction. A systematic review identified 36 clinical studies, 24 by oral or tube route and 12 by infusion, in patients with cancer: in the vast majority, glutamine improved nutritional status without increasing tumor growth. Its authors nevertheless note that objective evaluation of a supplement's effect on tumor growth was still lacking.
In 86 patients with metastatic colorectal cancer treated with oxaliplatin, 15 g of glutamine twice daily, 7 days every 2 weeks, reduced severe nerve damage after 4 cycles (4.8% versus 18.2%). The chemotherapy response rate (52.4% versus 47.8%), non-neurological serious toxicities and survival did not differ between groups.
Wang WS, Lin JK, Lin TC, et al. Oncologist 2007;12(3):312-319. DOI: 10.1634/theoncologist.12-3-312
The trial was small and had no placebo. In radiotherapy for head and neck cancers, two recent meta-analyses found no reduction in the frequency of mouth lesions; they diverged on their severity: one (6 trials, 441 patients) found no significant effect, the other (11 trials, 922 patients) found fewer severe cases, less opioid use, and fewer radiotherapy interruptions. Finally, in a Dutch cohort of 5,362 adults aged 55 and over, higher dietary intake of glutamic acid, a glutamine precursor, was associated with fewer colorectal cancers: a dietary association that says nothing about a supplement.
No human study shows that glutamine causes cancer. The hypothesis that a supplement nourishes an existing tumor is based on laboratory findings, and available clinical trials do not confirm it. In case of ongoing cancer treatment, the decision belongs to the oncology team.
Brain, mood, epilepsy: limited data
In the brain, glutamine is used to produce glutamate, the main excitatory messenger, hence a theoretical concern in case of epilepsy or mood disorder. No trial or case of epileptic seizure attributed to a glutamine supplement emerged from our PubMed search. The large critical care trial excluded epileptic patients under treatment, which is a precautionary measure and not an observed effect.
Regarding mood, a letter published in 1984 in the American Journal of Psychiatry, titled "L-glutamine and mania," reported manic episodes associated with L-glutamine use (letter indexed under the terms bipolar disorder and male sex); without an available abstract, neither the number of cases nor the doses can be specified. Conversely, in the trial of 15 g per day for 8 weeks, no neurological effect was observed, and in healthy volunteers infused at high doses, mental status tests remained normal.
Nothing demonstrates that glutamine causes seizures or mood disorders. In case of epilepsy or bipolar disorder, due to lack of data, medical advice is necessary before starting.
Pregnancy, breastfeeding, children, and seniors
Pregnancy and breastfeeding. No glutamine supplementation trial in pregnant women emerged from our search. Trials exclude pregnant and breastfeeding women, and the authors of the irritable bowel trial advise against applying their results to pregnancy and breastfeeding due to unknown effects on the fetus and young child. In the absence of data, we abstain; our product is moreover contraindicated in pregnant or breastfeeding women.
Children. Pediatric data exist, but in a medical context. In premature infants, a review of 12 trials involving 2,877 babies found neither benefit nor effect on mortality, which remains comparable with or without glutamine. The 48-week trial in sickle cell disease included patients from age 5, under medical supervision; it was funded by a pharmaceutical company whose several authors were employees. In 18 children with Crohn's disease, the glutamine-enriched formula was less effective than the standard formula and less well tolerated. Nothing justifies giving a glutamine supplement to a child without prescription.
Seniors. The kidneys lose capacity with age, and it is precisely in older adults with impaired kidney function that the authors of the acute kidney injury case recommend caution.
Pregnancy and breastfeeding: abstain. Children: medical use only. Older adults: first verify kidney function.
Interactions, risk table, and safety rules
Interactions. No study of interaction between a glutamine supplement and a medication emerged from our search. Two situations warrant caution, by simple physiological reasoning. The lactulose is used to lower ammonia, for example in hepatic encephalopathy, whereas glutamine raises it when the liver is diseased: if taking lactulose for this reason, no glutamine without medical advice. Antiepileptic medications have undergone no studies with glutamine; since it is used to produce glutamate, neurologist advice is preferable. Anyone on treatment should seek advice from a healthcare professional.
| Risk | What studies show | Verdict |
|---|---|---|
| Digestive disorders | Nausea, bloating, possible discomfort; at 15 g per day, 3.8% as with placebo | Established, infrequent |
| Mortality in critical care | 32.4% versus 27.2% at 28 days, with approximately 55 g per day by infusion and feeding tube, especially in case of kidney impairment according to exploratory analysis | Established, in this context only |
| Elevated ammonia levels | From 75 to 169 µmol/L one hour after 20 g in cases of cirrhosis, 52 to 78 in healthy controls | Established in cases of liver disease |
| Kidney impairment | One case of acute kidney failure with 18 g per day | Rare, not demonstrated |
| Liver, encephalopathy | One case of acute hepatitis, possible causality; one case of encephalopathy in intensive care | Rare, not demonstrated |
| Tumor growth | Demonstrated in laboratory; 36 clinical studies mostly without tumor progression | Theoretical |
| Cause cancer | No human data | Misconception |
| Mania | One letter from 1984; no neurological effects in trials | Rare, not demonstrated |
| Epilepsy | No cases found; glutamate precursor | Theoretical |
| Prolonged use at very high doses | Possible mechanisms, no long-term trials | Theoretical |
| Danger for the healthy athlete | No adverse effects reported in trials, ranging from several days to several weeks, with tolerability rarely measured | No signal, limited data |
| Pregnancy, breastfeeding | No trials | Unknown, abstention recommended |
The rules below are practical advice drawn from these studies, not tested as such in a trial.
Jaundice (yellowing of skin or whites of eyes), very dark urine, intense pain under the ribs on the right side, persistent nausea and vomiting: possible liver damage. Confusion, unusual drowsiness, attention or behavioral disorders: possible excess ammonia, especially in case of liver disease. Sharp decrease in urine volume, leg swelling, severe fatigue: possible kidney damage.
100% L-glutamine powder. One 5 g measuring spoon per day in a large glass of water or juice, or 2.5 g before and 2.5 g after exercise for athletes. Not recommended during pregnancy and breastfeeding and in case of kidney or liver disease except on medical advice; if taking medication, consult a healthcare professional.
View L-glutamineOur article on glutamine and muscle recovery details what trials show in athletes.
Frequently asked questions
Is glutamine dangerous?
Not for a healthy adult at common doses of 5 to 15 g per day, according to available trials: its adverse effects, mainly digestive, are no more frequent than with placebo. Documented danger concerns intensive care at very high doses and liver or kidney disease.
What are the side effects of glutamine?
Mainly mild digestive problems: nausea, bloating, abdominal discomfort, more likely at high doses. In an 8-week trial at 15 g per day, they affected 3.8% of participants, the same as with placebo. A few isolated cases of kidney or liver damage have been published, with no demonstrated cause-and-effect link.
What are the contraindications for glutamine?
Without medical advice: kidney or liver disease, cirrhosis, urea cycle disorder, cancer undergoing treatment, epilepsy, bipolar disorder, pregnancy, breastfeeding, children, hospitalization for serious illness.
Does glutamine promote cancer?
Tumor cells consume glutamine in the laboratory, but a review of 36 clinical studies in cancer patients does not find, in the vast majority, an increase in tumor growth. In a trial of 86 patients undergoing chemotherapy, survival and treatment response did not differ with or without glutamine.
Is glutamine bad for the kidneys?
No trial shows kidney damage in healthy people at common doses. One case of acute kidney failure was published in a patient taking 18 g per day, and in intensive care, according to exploratory analysis, the excess mortality risk mainly affected patients whose kidneys were already compromised. In case of kidney disease, medical advice is mandatory.
Is glutamine dangerous for the liver?
In people with cirrhosis, yes: 20 g of glutamine significantly raises blood ammonia, to the point where this test is used to screen for hepatic encephalopathy. In healthy people, our research found only one published case of acute hepatitis, with a link considered only possible. Jaundice requires stopping use and consulting a doctor.
Why did glutamine increase mortality in intensive care?
In the REDOXS trial, 1,223 patients in multiple organ failure received approximately 55 g of glutamine per day per 70 kilos, by infusion and feeding tube. Mortality at 28 days was 32.4% versus 27.2%. According to exploratory analysis, the excess risk was concentrated in patients with kidney damage. This result does not directly translate to a 5 g per day supplement in a healthy person.
What dose of glutamine per day is safe?
A safety review identifies 14 g per day as the intake level at which the absence of adverse effects is solidly documented in healthy adults (this is not a toxicity threshold). Long-term safety at very high intakes, such as 40 g per day, is not established.
Can you take glutamine while pregnant or breastfeeding?
No, without medical advice: no trials have evaluated glutamine as a supplement during pregnancy or breastfeeding. In the absence of data, abstention is the rule.
Does glutamine raise ammonia levels?
In healthy people, slightly: tolerance studies do not show notable ammonia increases, even after 0.3 g per kilo in a single dose. In case of cirrhosis, significantly: 75 to 169 micromoles per liter one hour after 20 g in one study, versus 52 to 78 in healthy controls. Confusion or unusual drowsiness require consulting a doctor.
Does glutamine have interactions with medications?
No drug interaction study has been published. As a precaution, a person taking lactulose for hepatic encephalopathy, anticonvulsants, or any other medication should consult their doctor.
Sources
The studies cited below were identified via PubMed.
- Heyland D, Muscedere J, Wischmeyer PE, et al. A randomized trial of glutamine and antioxidants in critically ill patients. The New England Journal of Medicine, 2013;368(16):1489-1497. DOI
- Zhou Q, Verne ML, Fields JZ, et al. Randomized placebo-controlled trial of glutamine supplementation in post-infectious irritable bowel syndrome. Gut, 2019;68(6):996-1002. DOI
- Shao A, Hathcock JN. Risk assessment of the amino acids taurine, L-glutamine and L-arginine. Regulatory Toxicology and Pharmacology, 2008;50(3):376-399. DOI
- Ziegler TR, Benfell K, Smith RJ, et al. Safety and metabolic effects of L-glutamine administration in humans. Journal of Parenteral and Enteral Nutrition, 1990;14(4 Suppl):137S-146S. DOI
- Lowe DK, Benfell K, Smith RJ, et al. Safety of glutamine-enriched parenteral nutrition solutions in humans. The American Journal of Clinical Nutrition, 1990;52(6):1101-1106. DOI
- Holecek M. Adverse effects of prolonged glutamine supplementation. Journal of Parenteral and Enteral Nutrition, 2013;37(5):607-616. DOI
- Holeček M. Adverse effects of amino acid supplements. Physiological Research, 2022;71(1):29-45. DOI
- Ogden HB, Fallowfield JL, Child RB, et al. No protective benefit of acute low-dose L-glutamine on intestinal permeability, epithelial injury and bacterial translocation during exercise heat stress: a randomized crossover trial. Temperature, 2022;9(2):196-210. DOI
- Niihara Y, Miller ST, Kanter J, et al. Phase 3 trial of L-glutamine in sickle cell disease. The New England Journal of Medicine, 2018;379(3):226-235. DOI
- Pugh JN, Sage S, Hutson M, et al. Glutamine supplementation reduces markers of intestinal permeability during heat running in a dose-dependent manner. European Journal of Applied Physiology, 2017;117(12):2569-2577. DOI
- Shuai T, Tian X, Xu LL, et al. Oral glutamine may provide no clinical benefit for preventing radiation-induced oral mucositis in adults with head and neck cancer: meta-analysis of randomized trials. Frontiers in Nutrition, 2020;7:49. DOI
- Akobeng AK, Miller V, Stanton J, et al. Randomized double-blind trial of a polymeric diet enriched with glutamine in active Crohn's disease. Journal of Pediatric Gastroenterology and Nutrition, 2000;30(1):78-84. DOI
- Candow DG, Chilibeck PD, Burke DG, et al. Effect of glutamine supplementation combined with resistance training in young adults. European Journal of Applied Physiology, 2001;86(2):142-149. DOI
- Ramezani Ahmadi A, Rayyani E, Bahreini M, Mansoori A. Effect of glutamine supplementation on athletic performance, body composition, and immunity: systematic review and meta-analysis of clinical trials. Clinical Nutrition, 2019;38(3):1076-1091. DOI
- Heyland DK, Elke G, Cook D, et al. Glutamine and antioxidants in critically ill patients: post hoc analysis of a large randomized trial. Journal of Parenteral and Enteral Nutrition, 2015;39(4):401-409. DOI
- van Zanten AR, Sztark F, Kaisers UX, et al. High-protein enteral nutrition enriched with immunomodulatory nutrients versus standard high-protein nutrition and nosocomial infections in the ICU: randomized clinical trial. JAMA, 2014;312(5):514-524. DOI
- Heyland DK, Wibbenmeyer L, Pollack J, et al. A randomized trial of enteral glutamine in the treatment of burns. The New England Journal of Medicine, 2022;387(11):1001-1010. DOI
- Pimentel RFW, Fernandes SL. Effects of parenteral glutamine in surgical patients in the ICU: systematic review and meta-analysis. Nutrición Hospitalaria, 2020;34(3):616-621. DOI
- Bhoelan S, Kürül S, Krol CG, et al. Acute kidney injury induced by L-glutamine: a clinical case report. Nephron, 2025;150(1):47-51. DOI
- Ditisheim S, Giostra E, Burkhard PR, et al. A capillary ammonia test at the bedside after glutamine loading to improve the diagnosis of hepatic encephalopathy in cirrhosis. BMC Gastroenterology, 2011;11:134. DOI
- Romero-Gómez M, Grande L, Camacho I. Prognostic value of an abnormal oral glutamine loading test in patients with minimal hepatic encephalopathy. Hepatology, 2004;39(4):939-943. DOI
- Cioccari L, Gautschi M, Etter R, et al. New concerns about glutamine: a case of hyperammonemic encephalopathy. Critical Care Medicine, 2015;43(10):e458-e460. DOI
- Hatami B, Saffaei A, Jamali F, Abbasinazari M. Hepatotoxicity induced by powdered glutamine: time to understand the side effects of sports nutrition supplements. Gastroenterology and Hepatology from Bed to Bench, 2020;13(1):86-89. DOI
- Altman BJ, Stine ZE, Dang CV. From Krebs to the clinic: glutamine metabolism to cancer treatment. Nature Reviews Cancer, 2016;16(10):619-634. DOI
- Kuhn KS, Muscaritoli M, Wischmeyer P, Stehle P. Glutamine, an essential nutrient in oncology: experimental and clinical data. European Journal of Nutrition, 2010;49(4):197-210. DOI
- Wang WS, Lin JK, Lin TC, et al. Oral glutamine is effective in preventing oxaliplatin-induced neuropathy in colorectal cancer patients. The Oncologist, 2007;12(3):312-319. DOI
- Alsubaie HM, Alsini AY, Alsubaie KM, et al. Glutamine to prevent and mitigate radiation-induced oral mucositis in head and neck squamous cell cancer: systematic review and meta-analysis of controlled trials. Head & Neck, 2021;43(10):3199-3213. DOI
- Viana Veloso GG, Franco OH, Ruiter R, et al. Baseline dietary glutamic acid intake and colorectal cancer risk: the Rotterdam Study. Cancer, 2016;122(6):899-907. DOI
- Mebane AH. L-glutamine and mania. The American Journal of Psychiatry, 1984;141(10):1302-1303. DOI
- Moe-Byrne T, Brown JV, McGuire W. Glutamine supplementation to prevent morbidity and mortality in preterm infants. Cochrane Database of Systematic Reviews, 2016;4(4):CD001457. DOI
