Just came across this study published last month, looked interesting and worth sharing.

https://www.mdpi.com/1999-4923/17/8/1004

Here's the abstract:

Abstract
...
We retrospectively reviewed the medical records of 100 patients diagnosed with primary fibromyalgia. Those showing symptoms indicative of small fiber dysfunction who were treated with L-Acetyl Carnitine (LAC) and Palmitoylethanolamide (PEA) alongside standard care (SOC) were compared to matched controls who received only SOC. To ensure comparable groups, propensity score matching was used. Changes in Fibromyalgia Impact Questionnaire Revised (FIQR) scores over 12 weeks were analyzed using non-parametric tests due to the data’s non-normal distribution. After matching, 86 patients (43 in each group) were included. The group receiving LAC and PEA as add-on therapy experienced a significant median reduction in FIQR scores (−19.0 points, p < 0.001), while the SOC-only group showed no significant change. Comparisons between groups confirmed that the improvement was significantly greater in the LAC+PEA group (p < 0.001). These results suggest that adding LAC and PEA to standard care may provide meaningful symptom relief for fibromyalgia patients with suspected small fiber involvement. This supports the hypothesis that peripheral nervous system dysfunction contributes to the disease burden in this subgroup. However, further prospective controlled studies are needed to confirm these promising findings.

There's a few other studies out there (https://pubmed.ncbi.nlm.nih.gov/17543140/, https://pmc.ncbi.nlm.nih.gov/articles/PMC7551150/, https://pubmed.ncbi.nlm.nih.gov/37378482/) finding similar positive outcomes, so while it's still early it seems promising to me.

Anecdotally, I've recently started taking them a few days ago (alongside creatine, which shouldn't have much effect this soon) and it's had a surprising effect on my energy levels and focus. I feel like I'm getting out of it some of what worked for me about SNRIs, without the things I didn't like about em. I'm vegetarian and LAC in food comes mostly from animal sources, so it's possible I had a deficiency before.

As always with supplements, do your research on the source and confirm they're third-party lab tested so you know you're getting what you expect, and avoid proprietary blends. I ordered mine from Nutricost, which passes the sniff test and was cheap enough. It also seems like LAC/PEA might have some effect on seratonin so if you're taking any other med with a seratonin syndrome warning, you'd probably wanna talk to a doctor about it.

Anyone else here tried LAC and/or PEA?