Pure L-Threonine 500 Milligrams by Montiff

POSSIBLY INEFFECTIVE

• Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease). Several small clinical studies suggest that oral threonine does not improve symptoms or slow the progression of ALS. Details: Small clinical trials show that taking threonine 2 grams daily for 7 days or 4 grams daily, divided into two or four doses, for up to 12 months does not seem to slow the progression of early-stage ALS or reduce symptoms when compared with placebo (681,12057,60069). There is also concern that threonine might actually worsen pulmonary function in these patients. The decline in forced vital capacity (FVC) associated with threonine therapy was about 2.5 times greater than that with placebo (681).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Familial spastic paraparesis (FSP). It is unclear if oral threonine is beneficial in patients with FSP. Details: A small clinical study in patients with FSP shows that taking threonine 1.5 grams to 2 grams three times daily for 2 weeks slightly improves some measures of motor impairment and spasticity when compared with placebo. However, these improvements do not seem to be clinically significant (12059).
• Multiple sclerosis (MS). It is unclear if oral threonine is beneficial in patients with MS. Details: A small clinical study in individuals with inactive or slowly progressive MS shows that taking threonine 2.5 grams three times daily for 8 weeks does not significantly reduce spasticity when compared with placebo (60073).
• Spasticity. It is unclear if oral threonine is beneficial in patients with spasticity. Details: A small clinical study in patients with spasticity arising from spinal cord injuries, multiple sclerosis, or syringomyelia shows that taking threonine 2 grams three times daily for 2 weeks slightly improves leg muscle tone when compared with placebo (12056). However, methodological concerns limit the validity of this finding. More evidence is needed to rate threonine for these uses.

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LIKELY SAFE ...when used orally in food amounts. Threonine as L-threonine in doses of 7-14 mg/kg daily (about 0.5-1 gram daily) has been suggested to be the minimum amount required to maintain a positive nitrogen balance in humans and is generally considered to be safe (60072,94096).

POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts. Taking threonine in doses up to 4 grams daily for up to 12 months seems to be safe (681,12056,12057,12059,60069).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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NMDA ANTAGONISTS Interaction Rating = Major Do not take this combination. Severity = Moderate •  Occurrence = Likely •  Level of Evidence = B Theoretically, threonine might decrease the effects of NMDA antagonists.  Details Threonine increases central nervous system (CNS) glycine levels (12058). Glycine seems to bind a site on NMDA receptors and enhance the activity of the receptors (681,12057).

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General ...Orally, threonine seems to be well tolerated.

Dermatologic ...Orally, skin rash has been reported in people who have taken threonine (681).

Gastrointestinal ...Orally, some patients can experience minor gastrointestinal upset including diarrhea (12056). Other side effects reported in people who have taken threonine include flatus and constipation (681).

Neurologic/CNS ...Orally, headache has been reported in people who have taken threonine (681).

Pulmonary/Respiratory ...Orally, rhinorrhea has been reported in people who have taken threonine (681).

Other ...Orally, a two-fold increase in serum ammonia levels occurred in one patient following administration of threonine 4 grams daily (681).

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