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The answer to this is that a multiplicity of scientific evidence points out that L-carnitine may not contribute to loss

Gynecomastia, characterized by breast enlargement, occurs in 44% of cirrhosis cases, also due to elevated estrogen levels, and is related to conditions like extreme obesity, hypogonadism, and various adrenal and testicular diseases (88, 89)

Moreover, synbiotics have been reported to improve gut integrity via SCFA production, by which inhibiting the TLR4LPS complex-triggered proinflammatory cascade, hampering proinflammatory cytokine signaling pathways, such as nuclear factor kappa B (NF-B), thereby decreasing insulin resistance (34)

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Challenges with combining molecularly target agents, Clinical Trial Design: Part 2: Clinical Trials Issues with Molecularly Targeted Agents, US