Condition
Cachexia
Cachexia is severe, unintended weight loss with muscle wasting, seen in cancer, heart failure, COPD and kidney disease, where inflammation drives muscle breakdown even when eating is adequate. The evidence is strongest for EPA omega-3s, protein, and oral nutritional supplements, which target inflammation, muscle building and calorie intake. Valine has very limited support: a small bed-rest study found less protein wasting, but the credit went to the amino acid mix.
Sources: PMID 10467608
- Supplements studied
- 2
- Graded outcomes
- 2
- Trials
- 2
- People studied
- 188
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Appetite Small Increase | Improves (the measure goes up) | Small effect | 1 study | 164 people | ||
| Quality of Life | Improves (the measure goes up) | 2 studies | 188 people | |||
Studies that measured quality of life
| ||||||
| Weight | Changes; see studies | 24 people | ||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Muscle Wasting Prevention A human study found that BCAA supplementation (including valine) attenuated protein wasting associated with bed rest. However, the effect is attributed to the BCAA mixture rather than isolated valine, and the specific contribution of valine versus leucine remains unclear. | Changes; see studies | Small effect | 5 studies | 60 people | ||
Key findings
- AppetiteImproves (the measure goes up)
- Muscle Wasting PreventionChanges; see studies
The Cachexia Supportive Care protocol
2 primary supplements · 7 supporting supplements
- Omega-3 Fatty Acids (EPA)2–4 g EPA+DHA daily (EPA-predominant formula)
- Protein/Amino Acids1.5–2.0 g/kg body weight daily; high-leucine sources preferred
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Cachexia. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
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Studies cited
100 studies from PubMed
- Regulation of Skeletal Muscle Function by Amino Acids.
- Short-Term Effects of Branched-Chain Amino Acids-Enriched Dialysis Fluid on Branched-Chain Amino Acids Plasma Level and Mass Balance: A Randomized Cross-Over Study.
- Branched-Chain Amino Acid Catabolism Promotes Thrombosis Risk by Enhancing Tropomodulin-3 Propionylation in Platelets.
- A Novel Dietary Intervention Reduces Circulatory Branched-Chain Amino Acids by 50%: A Pilot Study of Relevance for Obesity and Diabetes.
- Branched chain amino acids improve mesenchymal stem cell proliferation, reducing nuclear factor kappa B expression and modulating some inflammatory properties.
- Branched-chain amino acids promote endothelial dysfunction through increased reactive oxygen species generation and inflammation.
- Diabetes and branched-chain amino acids: What is the link?
- Branched-chain amino acids in health and disease: metabolism, alterations in blood plasma, and as supplements.
- Branched Chain Amino Acids: Beyond Nutrition Metabolism.
- Branched-Chain Amino Acids and Brain Metabolism.
- Insulin resistance and the metabolism of branched-chain amino acids.
- Branched-chain amino acids influence the immune properties of microglial cells and their responsiveness to pro-inflammatory signals.
- Branched-chain amino acids as pharmacological nutrients in chronic liver disease.
- Application of branched-chain amino acids in human pathological states: renal failure.
- Branched-chain amino acids: enzyme and substrate regulation.
- Effect of a keto acid-amino acid supplement on the metabolism and renal elimination of branched-chain amino acids in patients with chronic renal insufficiency on a low protein diet.
- Attenuation of the protein wasting associated with bed rest by branched-chain amino acids.
- Effects of oral, smoked, and vaporized cannabis on endocrine pathways related to appetite and metabolism: a randomized, double-blind, placebo-controlled, human laboratory study
- 1 -tetrahydrocannabinol, synhexyl and marijuana extract administered orally in man: catecholamine excretion, plasma cortisol levels and platelet serotonin content
- Acute effects of natural and synthetic cannabis compounds on prolactin levels in human males
- The effects of smoked marijuana on metabolism and respiratory control
- Effect of acute Δ9-tetrahydrocannabinol administration on subjective and metabolic hormone responses to food stimuli and food intake in healthy humans: a randomized, placebo-controlled study
- Explorative Placebo-Controlled Double-Blind Intervention Study with Low Doses of Inhaled Δ9-Tetrahydrocannabinol and Cannabidiol Reveals No Effect on Sweet Taste Intensity Perception and Liking in Humans
- Short-term effects of cannabinoids on immune phenotype and function in HIV-1-infected patients
- A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men
- Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial
- Acute and residual mood and cognitive performance of young adults following smoked cannabis
- Effects of acute marijuana smoking on pulse rate and mood states in women
- Assessment of Efficacy and Tolerability of Medicinal Cannabinoids in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysis
- Sativex ® as add-on therapy vs. further optimized first-line ANTispastics (SAVANT) in resistant multiple sclerosis spasticity: a double-blind, placebo-controlled randomised clinical trial
- Sativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosis
- Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up
- Multiple sclerosis and extract of cannabis: results of the MUSEC trial
- A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis
- Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients
- Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis
- Psychopathological and cognitive effects of therapeutic cannabinoids in multiple sclerosis: a double-blind, placebo controlled, crossover study
- A placebo-controlled, parallel-group, randomized withdrawal study of subjects with symptoms of spasticity due to multiple sclerosis who are receiving long-term Sativex® (nabiximols)
- Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosis
- Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial
- A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis
- A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex(®) ), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis
- Tetrahydrocannabinol and cannabidiol oromucosal spray in resistant multiple sclerosis spasticity: consistency of response across subgroups from the SAVANT randomized clinical trial
- Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis
- Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study
- Short-term effects of smoking marijuana on balance in patients with multiple sclerosis and normal volunteers
- The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS)
- Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis
- Smoked marijuana effects on tobacco cigarette smoking behavior
- Abstinence symptoms following smoked marijuana in humans
- Abstinence symptoms following oral THC administration to humans
- Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition
- Acute and residual effects of smoked cannabis: Impact on driving speed and lateral control, heart rate, and self-reported drug effects
- Effect of cannabis use on cognitive functions and driving ability
- Cannabis smoking impairs driving performance on the simulator and real driving: a randomized, double-blind, placebo-controlled, crossover trial
- Acute effects of smoking marijuana on hormones, subjective effects and performance in male human subjects
- The effects of orally administered delta 9-tetrahydrocannabinol in man on mood and performance measures: a dose-response study
- Opioid antagonism enhances marijuana's effects in heavy marijuana smokers
- Cannabis use and driving-related performance in young recreational users: a within-subject randomized clinical trial
- Sex differences in the effects of marijuana on simulated driving performance
- Effect of Cannabidiol and Δ9-Tetrahydrocannabinol on Driving Performance: A Randomized Clinical Trial
- Subjective aggression during alcohol and cannabis intoxication before and after aggression exposure
- Cannabinoids for adult cancer-related pain: systematic review and meta-analysis
- An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics
- Comparison of the analgesic effects of dronabinol and smoked marijuana in daily marijuana smokers
- Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain
- Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers
- Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers
- Amygdala activity contributes to the dissociative effect of cannabis on pain perception
- Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial
- Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies
- Results of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as an Adjunctive Therapy in Advanced Cancer Patients with Chronic Uncontrolled Pain
- The Effects of Dosage-Controlled Cannabis Capsules on Cancer-Related Cachexia and Anorexia Syndrome in Advanced Cancer Patients: Pilot Study
- Effect of marihuana on intraocular and blood pressure in glaucoma
- Cannabis for dyskinesia in Parkinson disease: a randomized double-blind crossover study
- Regional cerebral blood flow after marijuana smoking
- The effects of smoking marihuana on physical performance
- Marijuana's dose-dependent effects in daily marijuana smokers
- Middle cerebral artery velocity during upright posture after marijuana smoking
- Association between marijuana exposure and pulmonary function over 20 years
- Acute effects of marihuana smoking on maximal exercise performance
- Cannabis induces a clinical response in patients with Crohn's disease: a prospective placebo-controlled study
- Effect of Inhaled Cannabis for Pain in Adults With Sickle Cell Disease: A Randomized Clinical Trial
- Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study
- Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy
- Randomized placebo-controlled double-blind clinical trial of cannabis-based medicinal product (Sativex) in painful diabetic neuropathy: depression is a major confounding factor
- Postural syncope after marijuana: a transcranial Doppler study of the hemodynamics
- A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment
- Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial
- Smoked cannabis for chronic neuropathic pain: a randomized controlled trial
- Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
- Systematic review and meta-analysis of cannabis treatment for chronic pain
- A role for cannabinoids in the treatment of myotonia? Report of compassionate use in a small cohort of patients
- An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia
- Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial
- Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis
- Acute effects of marihuana on luteinizing hormone in menopausal women
- Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults
- Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group
- Evaluating the Suitability and Potential Efficiency of Cannabis sativa Oil for Patients with Primary Burning Mouth Syndrome: A Prospective, Open-Label, Single-Arm Pilot Study