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An important limitation also concerns potential selection bias
Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the Korea Food and Drug Administration
Common side effects of taking too much include: Nausea or an upset stomach Heartburn Diarrhea A mild "fishy" body odor (this happens when the body breaks down high doses of the supplement) Additionally, recent studies highlighted by organizations like the Cleveland Clinic have noted that gut bacteria can interact with L-carnitine to produce a compound called TMAO (trimethylamine N-oxide)
Shared decision-making, gradual dose titration, patient education, and close monitoring are key strategies to mitigate adverse effects and improve satisfaction
They work best when coupled with lifestyle and behavior change
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