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At the extreme end of this situation, where there is a genetic deficit in carnitine biosynthesis, some nasty stuff happens without carnitine supplementation [1]: Liver damage and dysfunction Brain damage Muscle weakness Lethargy Exercise intolerance Yet, there can also be situations of mild deficiency where these overt signs arent present

Nature Metabolism thanks Brian Finan and the other, anonymous, reviewer(s) for their contribution to the peer review of this work

Contamination prevention: Always swab the vial stopper with alcohol before each needle insertion

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Cloudiness indicates either bacterial contamination or peptide precipitation from improper mixing or temperature shock