From the Research
The treatment of lipid storage myopathy primarily involves dietary modifications and supplementation with specific nutrients, with a focus on reducing lipid accumulation in muscle tissue and improving mitochondrial function, as discussed in the most recent review of metabolic lipid muscle disorders 1. The cornerstone of management is a low-fat, high-carbohydrate diet, which helps reduce the accumulation of lipids in muscle tissue.
- Supplementation with riboflavin (vitamin B2) at doses of 100-400 mg daily is recommended, as many forms of lipid storage myopathy result from defects in mitochondrial fatty acid oxidation where riboflavin is a crucial cofactor.
- Coenzyme Q10 supplementation (100-600 mg daily) is also beneficial due to its role in the mitochondrial respiratory chain.
- L-carnitine supplementation (1-3 g daily) is essential for patients with primary carnitine deficiency or secondary carnitine depletion, as it facilitates the transport of long-chain fatty acids into mitochondria for oxidation, as shown in a study of successful treatment of familial idiopathic lipid storage myopathy with L-carnitine and modified lipid diet 2.
- Medium-chain triglyceride (MCT) oil can be used as an alternative energy source since it bypasses the defective long-chain fatty acid metabolism. During metabolic crises, intravenous glucose administration may be necessary to provide alternative energy substrates. Regular monitoring of clinical symptoms, muscle strength, and biochemical parameters is important to assess treatment efficacy, as emphasized in a review of lipid storage myopathies 3. Physical therapy should be incorporated to maintain muscle function and prevent contractures. The specific treatment regimen should be tailored to the underlying subtype of lipid storage myopathy, as different genetic defects may require slightly different approaches, and treatment with prednisone, carnitine, vitamins, and food containing carnitine-rich ingredients can be effective, as reported in a study of clinicopathological changes in patients with lipid storage myopathy 4. A more recent study also highlights the importance of oral levo-carnitine therapy in patients with lipid storage myopathy, suggesting the possibility of carnitine deficiency as the most likely etiology in some cases 5.