Proc Soc Exp Biol Med (1994) 207:2633

The complete side effect frequency breakdown from Phase 2 trials: Very Common (20%+ of patients at 12mg dose) Nausea: 28% Typically mild to moderate, peaks weeks 4-8, usually resolves by week 12 Diarrhea: 24% Usually transient (1-3 weeks), rarely severe Constipation: 21% Paradoxically coexists with diarrhea in different patients Common (10-20% of patients) Vomiting: 17% Decreased appetite: 16% (beyond therapeutic effect) Injection site reactions: 14% Fatigue: 13% Dyspepsia (indigestion): 12% Headache: 11% Uncommon (2-10% of patients) Abdominal pain: 8% Dizziness: 7% Gastroesophageal reflux: 6% Hypoglycemia in diabetics on other medications: 5% Increased heart rate (average 2-4 bpm): 4% Hair thinning/loss: 3% (typically temporary) Rare but Serious (Under 2%) Pancreatitis: 0.3% (3 cases out of 1,032 patients, all resolved with discontinuation) Gallbladder events: 1.4% (expected with rapid weight loss regardless of method) Acute kidney injury: 0.7% (all cases associated with severe dehydration) KEY TAKEAWAY: About 30% experience meaningful nausea in the first 4-8 weeks

Before starting any new supplement, it is advisable to: Consult your GP or a registered pharmacist , particularly if you have an existing medical condition, are pregnant or breastfeeding, or are taking prescribed medications Check the product label carefully for dosage instructions, ingredient lists, and any allergen information Choose products from reputable manufacturers that comply with UK food supplement regulations enforced by the FSA Avoid exceeding the manufacturer's recommended dose , as higher doses have not been shown to confer additional benefit and may increase the risk of adverse effects Additional cautions apply to specific groups: People with kidney (renal) disease should seek medical advice before taking L-carnitine supplements, as unsupervised use is not recommended in this group Children and adolescents should not take L-carnitine supplements unless specifically advised to do so by a clinician People taking anticoagulants such as warfarin should speak to their GP or anticoagulation service before use

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