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Haematological symptoms typically appear first and include fatigue, weakness, and pallor due to megaloblastic anaemiaa condition where the bone marrow produces abnormally large, immature red blood cells that function poorly

It moves fatty acids into the cells to be converted into energy

Compared to placebo, the treatment with intramuscular acetyl-l-carnitine significantly reduced weekly mean pain on the VAS, whilst during the open-label part of the study, oral acetyl-l-carnitine improved symptoms in the entire cohort, with no safety issues [81] (Table 2)

no antibody formation, no cortisol dysregulation, no prolactin elevation throughout study

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