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Despite these positive findings, the study is not without its limitations

Carnitine deficiency results in a reduced oxidation (breakdown) of fatty acids and therefore, reduced energy (ATP) production

Acylcarnitine subsequently increases the activity of mitochondrial electron transport chain complexes and mitochondrial OXPHOS by promoting the acetylation of H3K27

Total and LDL cholesterol levels increased in the L-carnitine group, and L-carnitine supplementation was also associated with 9.3% greater carotid arterial plaque stenosis in males who ate less red meat and had lower baseline stenosis and total plaque volume than other participants.26 A 2018 study including participants on a nonvegetarian diet found that 24 weeks of supplementation with 1,500 mg of L-carnitine increased fasting blood levels of carnitine and increased levels of TMAO tenfold but did not increase lipids, inflammatory markers, or other markers of atherosclerosis in healthy, omnivore, nonsmoking, physically active women ages 65 to 70 when compared with placebo