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10.1007/s00125-014-3283-z Diabetologia 113 YangF.TakagakiY.YoshitomiY.IkedaT.LiJ.KitadaM.et al (2019)

It is worth noting that individuals with pre-existing circulatory conditions, such as peripheral arterial disease or Raynaud's phenomenon, may notice their symptoms become more apparent during treatment with any medication that causes weight loss or metabolic changes

They do not replace nutrition, strength training, cardio, sleep, or medical guidance

Second, the relationship between physical function and skeletal muscle mass were not assessed, which may explain the effect of L-carnitine on sarcopenia

It deserves emphasis that to date there is no rigorous evidence for a programmed neurotoxic astrocyte phenotype that is somehow activated in a common manner across multiple disorders and represents a universal target, in spite of certain claims to this effect