August 27, 2019

Supplement Octanoic Acid May Help with Vocal Tremor

A fascinating study came out August 2019 that treated patients with vocal tremor with an over-the-counter supplement called octanoic acid, more commonly known as caprylic acid.

The theory behind using octanoic acid (OA) comes from the observation that OA works similarly to alcohol (but without the side effects); alcohol often helps reduce limb and hand tremor and is thought to act centrally within the olivocerebellar region of the brain.

Given that OA is thought to work the same way as alcohol, studies have been carried out confirming that OA does indeed help to reduce limb tremor.

Given OA helps with limb tremor, the hope is that OA can also help with vocal tremor... and at least based on this preliminary double-blind, placebo-controlled study, it does.

The magnitude of vocal tremor amplitude and frequency were significantly lower after 3 weeks of octanoic acid as compared to the placebo condition. Unfortunately, auditory‐perceptual ratings of tremor severity did not show significant differences between conditions.

The dosing used in the study was 16mg/kg for 20 days followed by a final dose of 32mg/kg on the final day of the study time period.

This dosing basically works out to about 500-600mg twice a day for the average adult.

Something to consider trying in patients suffering from vocal tremor.

References:
The Effect of Octanoic Acid on Essential Voice Tremor: A Double‐Blind, Placebo‐Controlled Study. Laryngoscope, 129:1882–1890, 2019

Predictors of alcohol responsiveness in dystonia. Neurology. November 20, 2018; 91 (21)

Octanoic acid in alcohol-responsive essential tremor: a randomized controlled study. Neurology. 2013 Mar 5;80(10):933-40. doi: 10.1212/WNL.0b013e3182840c4f. Epub 2013 Feb 13.

An open-label, single-dose, crossover study of the pharmacokinetics and metabolism of two oral formulations of 1-octanol in patients with essential tremor. Neurotherapeutics. 2011 Oct;8(4):753-62. doi: 10.1007/s13311-011-0045-1.

Dose-escalation study of octanoic acid in patients with essential tremor. J Clin Invest. 2016 Apr 1;126(4):1451-7. doi: 10.1172/JCI83621. Epub 2016 Feb 29.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. He is also the chief medical officer of O2Labz, a medical and scientific 3D animation company.

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