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Overall, there is not sufficient evidence to recommend B12 on its own for the elderly with impaired cognitive function, although those with early symptoms may benefit

It can feel itchy and mildly painful

Perry T, Lahiri DK, Sambamurti K, et al

The functions of L-carnitine include transport of long-chain fatty acids across the mitochondrial membranes into the mitochondria (wherein their metabolism produces bioenergy) and transport of small-chain and medium-chain fatty acids out of the mitochondria in order to, among other things, maintain normal coenzyme A levels in these organelles

It increases the dose at a moderate rate faster than a conservative plan, but still gradual enough to manage side effects