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Chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in accumulation of the potentially toxic metabolites, trimethylamine and trimethylamine-N-oxide, since these metabolites are normally excreted in the urine

The arachnoid mater is also reinforced by tight junctions and demarcates the dura from the subarachnoid space

2024;20:211 Klotsman M, Adin CA, Anderson WH, Gilor C

Papers: Langer Sawicka-Gutaj Batsis Heymsfield if only there was a clinical trial out there designed to measure both quantity (muscle too) and quality (function too) changes both with and without exercise in patients taking contemporary GLP-1-based therapies

"L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women." International journal of sport nutrition and exercise metabolism 10.2 (2000): 199-207

Even at very low doses, consistent daily or weekly dosing produces accumulation