Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
2-Amino-3-hydroxybutyric acid, glycine, L-(-)-threonine, L-thréonine (French), serine, (S)-threonine, threonine, thréonine (French), threoninum (Latin), treonina (Spanish).
Threonine is an important amino acid that is a building block for proteins in the body. Some foods that are high in L-threonine are cottage cheese, watercress, sesame seeds, soy, meat and fish, lentils, eggs, milk, and gelatin.
L-threonine has been studied in the treatment of nerve disorders like amyotrophic lateral sclerosis (ALS), multiple sclerosis, and muscle spasms. However, more research is needed.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
L-threonine taken by mouth for two weeks has been shown to benefit people who have muscle spasms. More research is needed.
Amyotrophic lateral sclerosis (ALS)
L-threonine has been studied in the treatment of amyotrophic lateral sclerosis (ALS), a severe progressive nerve disorder. However, there is not enough evidence to support this use at this time. Some studies suggest that L-threonine may decrease survival in people with ALS. More research is needed.
Multiple sclerosis (MS)
There is not enough evidence to support the use of L-threonine for muscle spasms in people who have multiple sclerosis. More research is needed before a conclusion may be made.
Spinal cord injury
L-threonine has been studied for use in treating muscle spasms related to spinal cord injuries. Although there is some supporting evidence, more research is needed before a conclusion may be made.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Energy, HIV, immune function, mental illness, muscle strength, nervous system disorders, skin care, stomach complaints, stress, tooth disease.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
To treat amyotrophic lateral sclerosis (ALS), two grams of L-threonine has been taken by mouth once daily for one week.
To treat multiple sclerosis, 7.5 grams of L-threonine has been taken by mouth daily in three divided doses for eight weeks.
To treat muscle spasms, 4.5 grams or six grams of L-threonine has been taken by mouth daily in three divided doses for two weeks.
To treat muscle spasms caused by spinal cord injury, six grams of L-threonine has been taken by mouth daily in three divided doses for up to two weeks.
Children (under 18 years old)
There is no proven safe or effective dose for L-threonine in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid if allergic or sensitive to L-threonine or to ingredients found in L-threonine supplements.
Side Effects and Warnings
L-threonine is likely safe when taken by mouth in recommended doses in healthy people for up to one year.
L-threonine may cause side effects such as constipation, diarrhea, gas, headaches, indigestion, nausea, runny nose, skin rash or warmth, or upset stomach.
Use cautiously in people who have amyotrophic lateral sclerosis (ALS). Some research suggests that L-threonine may decrease survival in people with ALS.
Use cautiously in people who have stomach disorders.
Avoid in people who have Alzheimer's disease or those taking NMDA antagonists. L-threonine may decrease the effectiveness of these drugs in people who have Alzheimer's.
Avoid in children and in pregnant or breastfeeding women, due to a lack of safety data.
Avoid if allergic or sensitive to L-threonine or to ingredients found in L-threonine supplements.
Pregnancy and Breastfeeding
There is currently a lack of scientific evidence on the use of L-threonine during pregnancy or breastfeeding.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
L-threonine may interact with agents that may affect the nervous system, agents that may treat Alzheimer's disease, agents that may treat skin disorders, agents that may treat stomach disorders, agents that may treat stuffy nose, cholesterol-lowering agents, medroxyprogesterone acetate, muscle relaxants, NMDA antagonists, and pain relievers.
Interactions with Herbs and Dietary Supplements
L-threonine may increase the absorption of nutrients in the body.
L-threonine may interact with cholesterol-lowering herbs and supplements, herbs and supplements that may affect the nervous system, herbs and supplements that may treat Alzheimer's disease, herbs and supplements that may treat skin disorders, herbs and supplements that may treat stomach disorders, herbs and supplements that may treat stuffy nose, L-tryptophan, muscle relaxants, and pain relievers.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Blin, O, Desnuelle, C, Guelton, C, et al. [Anomaly in the neurotransmitter amino acids in amyotrophic lateral sclerosis: a therapeutic application]. Rev.Neurol.(Paris) 1991;147(5):392-394. View Abstract
Blin, O, Pouget, J, Aubrespy, G, et al. A double-blind placebo-controlled trial of L-threonine in amyotrophic lateral sclerosis. J.Neurol. 1992;239(2):79-81. View Abstract
Borgonha, S, Regan, MM, Oh, SH, et al. Threonine requirement of healthy adults, derived with a 24-h indicator amino acid balance technique. Am.J.Clin.Nutr. 2002;75(4):698-704. View Abstract
Bromberg, MB, Fries, TJ, Forshew, DA, et al. Electrophysiologic endpoint measures in a multicenter ALS drug trial. J.Neurol.Sci. 2-15-2001;184(1):51-55. View Abstract
Dong, X, Quinn, PJ, and Wang, X. Metabolic engineering of Escherichia coli and Corynebacterium glutamicum for the production of L-threonine. Biotechnol.Adv. 2011;29(1):11-23. View Abstract
Godard, MP, Williamson, DL, and Trappe, SW. Oral amino-acid provision does not affect muscle strength or size gains in older men. Med.Sci.Sports Exerc. 2002;34(7):1126-1131. View Abstract
Hauser, SL, Doolittle, TH, Lopez-Bresnahan, M, et al. An antispasticity effect of threonine in multiple sclerosis. Arch.Neurol. 1992;49(9):923-926. View Abstract
Hsieh JTC, Wolfe DL, Connolly S, et al. Spasticity after spinal cord injury: an evidence-based review of current interventions. Topics in Spinal Cord Injury Rehabilitation (TOP SPINAL CORD INJ REHABIL) 2007;13(1):81-97.
Lee, A and Patterson, V. A double-blind study of L-threonine in patients with spinal spasticity. Acta Neurol.Scand. 1993;88(5):334-338. View Abstract
Parton, M, Mitsumoto, H, and Leigh, PN. WITHDRAWN: Amino acids for amyotrophic lateral sclerosis / motor neuron disease. Cochrane.Database.Syst.Rev. 2008;(2):CD003457. View Abstract
Rochon, C, Prod'homme, M, Laurichesse, H, et al. Effect of medroxyprogesterone acetate on the efficiency of an oral protein-rich nutritional support in HIV-infected patients. Reprod.Nutr.Dev. 2003;43(2):203-214. View Abstract
Shakespeare, DT, Boggild, M, and Young, C. Anti-spasticity agents for multiple sclerosis. Cochrane.Database.Syst.Rev. 2003;(4):CD001332. View Abstract
Testa, D, Caraceni, T, Fetoni, V, et al. Chronic treatment with L-threonine in amyotrophic lateral sclerosis: a pilot study. Clin.Neurol.Neurosurg. 1992;94(1):7-9. View Abstract
van der Schoor, SR, Wattimena, DL, Huijmans, J, et al. The gut takes nearly all: threonine kinetics in infants. Am.J.Clin.Nutr. 2007;86(4):1132-1138. View Abstract
Wilson, DC, Rafii, M, Ball, RO, et al. Threonine requirement of young men determined by indicator amino acid oxidation with use of L-[1-(13)C]phenylalanine. Am.J.Clin.Nutr. 2000;71(3):757-764. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017