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The medication carries a boxed warning regarding thyroid C-cell tumors observed in rodent studies, though the relevance to humans remains uncertain

Briefly, in the feeding state, dietary L-carnitine supplementation can increase lipid catabolism to produce more energy by stimulating mitochondrial FA -oxidation and reducing FA and TG synthesis, utilising the protein sparing effect to elevate protein synthesis

45 The second step is an irreversible rate-limiting reaction catalyzed by branched-chain -keto acid dehydrogenase (BCKDH), which is phosphorylated and inactivated by the specific kinase BCKDH kinase (BCKDK) and dephosphorylated and activated by Protein phosphatase 1 K (PPM1K)

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