These exposures are not rare, seasonal, or accidental: they are constant, cumulative, and quietly stored in the liver, kidneys, lymphatics, bloodstream, brain, and fat tissue over time
Administration can occur simultaneously or separately based on convenience
The findings of a recent systematic review and meta-analysis of randomized clinical trials regarding l-carnitine supplementation showed an amelioration of muscle soreness and an improvement in muscle damage biomarkers, due to a decrease in lactate dehydrogenase, myoglobin and creatine kinase [97]
Symptomatic patients have a waxing and waning course and may present with complaints of fatigue (75%), pruritus (25% to 70%), jaundice (30% to 69%), abdominal pain (16% to 37%), and weight loss (10% to 34%)