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8,9 Manifestations Vitamin B 12 deficiency affects multiple systems, and sequelae vary in severity from mild fatigue to severe neurologic impairment 1,2,6,10 (Table 2 4,10 )

Cellular Biomarkers Cellular biomarkers cannot be evaluated in vivo in humans

19 A 2006 Cochrane review showed modest weight loss with exercise alone (1.1 to 8.8 lb [0.5 to 4.0 kg]), but the effect was not as significant as when exercise was combined with dietary modification (7.5 to 39.0 lb [3.4 to 17.7 kg])

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However, the evidence regarding the direct impact of L-carnitine supplementation on weight loss is limited and inconsistent