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As a supplement, acetyl-L-carnitine is usually considered safe when taken as directed

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Wang HY, Bakshi K, Frankfurt M, Stucky A, Goberdhan M, Shah SM, et al

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The specific mechanism by which enzymatic reactions cause lipid peroxidation is that Acyl-CoA synthetase long-chain family member 4 (ACSL4) and Lysophosphatidylcholine acyltransferase-3 (LPCAT3) first activate polyunsaturated fatty acids (PUFAs) to bind to lipids in the cell membrane (e.g., phosphatidylethanolamine PE), forming the PUFA-PE complex (Su et al., 2019)