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Digestive Upset: Some individuals may experience gastrointestinal symptoms such as nausea, diarrhea, or abdominal cramps, particularly with high doses of L-carnitine

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71(13): 157989 Schwarz D, Kisselev P, Roots I

The enzyme carnitine palmitoyltransferase II (CPT II) which is localized in the inner mitochondrial membrane converts acylcarnitines back to acyl CoAs and free L-carnitine, which exits the mitochondria and serves as the substrate for CPT I to form more acylcarnitine [1, 43]