L-Glutamine and Reduced Oral Mucositis Severity

Research synthesisModerate evidenceSmall effect5 studies · 3 beneficial · 2 neutral · 0 harmful

Across 5 studies, 3 reported beneficial effects of L-glutamine on reducing oral mucositis severity, with effect sizes ranging from small to moderate. The evidence includes a meta-analysis and a recent RCT showing statistically significant benefits, while 2 studies (both systematic reviews or RCTs) found neutral effects. The median study duration was 49 days (reported in 1 study), and the most studied population is cancer patients undergoing treatment.

Studied populations: cancer patients (including head and neck cancer and pediatric cancer) receiving chemotherapy or radiotherapy

Caveats: Available evidence is overwhelmingly positive — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). Evidence base is small (only 5 studies) — conclusions should be considered preliminary. Two of the five studies did not find significant effects, and doses were inconsistently reported across studies.

Generated Jul 12, 2026

Doses used in studies

g/day: 5 (median 5, IQR 5–5) — 1 study

Time to effect

Median: 7 weeks · IQR 7 weeks–7 weeks · Range 7 weeks–7 weeks — Reported in 1 of 5 studies

Safety in these studies

Overall tolerabilityReported
Ten interventions were found to have some benefit with regard to preventing or reducing the severity of mucositis associated with cancer treatment.
from: Interventions for preventing oral mucositis for patients with cancer receiving treatment.

5 of 5 papers

Interventions for preventing oral mucositis for patients with cancer receiving treatment.
- 2011-04-13
- Meta-Analysis · n = 131
- The Cochrane database of systematic reviews 2021(3)
- - Helen V Worthington
  - Jan E Clarkson
  - Gemma Bryan
  - Susan Furness
  - Anne-Marie Glenny
  - Anne Littlewood
  - Martin G McCabe
  - Stefan Meyer
  - Tasneem Khalid
- PubMed: 21491378
- DOI: 10.1002/14651858.cd000978.pub5
1 Insight on
- Reduced Oral Mucositis Severity
- High evidence
- Highly Cited
- Clinical
Ten interventions, where there was more than one trial in the meta-analysis, showed some statistically significant evidence of a benefit (albeit sometimes weak) for either preventing or reducing the severity of mucositis, compared to either a placebo or no treatment. These ten interventions were: aloe vera, amifostine, cryotherapy, granulocyte-colony stimulating factor (G-CSF), intravenous glutamine, honey, keratinocyte growth factor, laser, polymixin/tobramycin/amphotericin (PTA) antibiotic pastille/paste and sucralfate.
Effect
Beneficial
Effect size
Small
Significant
Yes
L-arginine vs. L-glutamine oral suspensions for radiation-induced oral mucositis: a triple-blind randomized trial.
- 2025-07-03
- RCT · n = 23
- Journal of cancer research and clinical oncology 151(7)
- - Fatma E A Hassanein
  - Christine Mikhail
  - Sarah Elkot
  - Asmaa Abou-Bakr
- PubMed: 40603739
- DOI: 10.1007/s00432-025-06213-x
6 Insights on
- Reduced Oral Mucositis Severity
- High evidence
- Clinical
By week 5, WHO scale scores differed significantly among groups (p < 0.001), with arginine and glutamine groups exhibiting lower mucositis severity than the maltodextrin group.
Effect
Beneficial
Effect size
Moderate
Significant
Yes
Dose
5 g + maltodextrin 5 g
Nutritional and Supplemental Interventions for Prevention and Treatment of Oral Mucositis in Pediatric Oncology.
- 2025-11-11
- Systematic Review
- Nutrients 17(22)
- - Razvan Mihai Horhat
  - Alexandru Alexandru
  - Cristiana-Smaranda Ivan
  - Norberth-Istvan Varga
  - Madalina-Ianca Suba
  - Elena Ciurariu
  - Monica Susan
  - Razvan Susan
  - Adrian Cote
- PubMed: 41305573
- DOI: 10.3390/nu17223521
4 Insights on
- Reduced Oral Mucositis Severity
- High evidence
- Rigorous Journal
- Clinical
Interventions tested included systemic supplements (e.g., glutamine, zinc, and bovine colostrum), topically applied agents (e.g., honey, vitamin E, Aloe vera, and olive oil), and nutrient-containing rinses (e.g., chamomile, Caphosol, and Traumeel S). Honey-based interventions showed promising outcomes.
Effect
Neutral
Effect size
Small
Significant
No
Update on the treatment of chemotherapy and radiotherapy-induced buccal mucositis: a systematic review.
- 2023-04-29
- Systematic Review
- Acta odontologica latinoamericana : AOL 36(1)
- - Schilin Wen
  - Leonardo Brito
  - Javiera Santander
  - Gonzalo Conteras
- PubMed: 37314054
- DOI: 10.54589/aol.36/1/3
1 Insight on
- Reduced Oral Mucositis Severity
- High evidence
- Clinical
Dentoxol mouthwashes, Plantago major extract, thyme honey extract, zinc oxide paste, vitamin B complex combined with GeneTime, and the consumption of L-glutamine are effective in diminishing the severity of OM.
Effect
Beneficial
Effect size
Moderate
Significant
Yes
Effects of L-glutamine and hyaluronic acid associated with photobiomodulation on oral mucositis: a randomized clinical trial.
- 2025-04-28
- RCT · n = 24
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 33(5)
- - Rodrigo Wilmes Dos Santos
  - Allisson Filipe Lopes Martins
  - Sebastião Silvério Sousa-Neto
  - Marília Oliveira Morais
  - Victor Hugo Lopes de Oliveira Moreira
  - Diego Antonio Costa Arantes
  - Angélica Ferreira Oton-Leite
  - Nilceana Maya Aires Freitas
  - Cláudio Rodrigues Leles
  - Elismauro Francisco Mendonça
- PubMed: 40295318
- DOI: 10.1007/s00520-025-09480-z
3 Insights on
- Reduced Oral Mucositis Severity
- High evidence
- Clinical
There were no differences when using the NCI scale.
Effect
Neutral
Effect size
Small
Significant
No

L-Glutamine and Reduced Oral Mucositis Severity

Interventions for preventing oral mucositis for patients with cancer receiving treatment.

L-arginine vs. L-glutamine oral suspensions for radiation-induced oral mucositis: a triple-blind randomized trial.

Nutritional and Supplemental Interventions for Prevention and Treatment of Oral Mucositis in Pediatric Oncology.

Update on the treatment of chemotherapy and radiotherapy-induced buccal mucositis: a systematic review.

Effects of L-glutamine and hyaluronic acid associated with photobiomodulation on oral mucositis: a randomized clinical trial.