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It is produced by the liver and nerve cells in the central nervous system

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First, lack of exposure is possible, as we lacked information on patient compliance with prescribed treatments and potential lack of medication dispensed at hospitals, however as medication compliance is similar across all three groups and we defined exposure as redeemed prescriptions, ensuring that the medication was actively collected by the patient, systematic misclassification is unlikely

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Possible side effects may include mild injection-site irritation, temporary headaches, or brief flushing

Timing matters too: several trials and mechanistic studies found that taking Lcarnitine with a meal that modestly raises insulin can improve muscle uptake because insulin increases carnitine transport into muscle cells