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** In subjects with severely impaired renal function or on dialysis, chronic oral administration of L-carnitine may cause accumulation of TMA and TMAO in the blood resulting in trimethylaminuria, a pathological condition characterized by a strong "fishy odor" present in the urine, breath and sweat of the patient

"Cross-over trial studies are required to further confirm these findings." Source: Cephalalgia

10.1097/00000542-200405000-00020 Anesthesiology 42 FreoU.OriC

A 2016 study showed that exercise in mice induced an increase in BHB, which in turn would lead to upregulation of Bdnf gene expression in the hippocampus (Sleiman et al., 2016)

Furthermore, L-carnitine maintains optimal acyl-CoA to free CoA ratios within mitochondria, consequently modulating carbohydrate and protein metabolic processes