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Although naturally produced by the body, you can become deficient in L-carnitine

Acetyl-L-carnitine and/or liposomal co-enzyme Q10 prevent propionic acid-induced neurotoxicity by modulating oxidative tissue injury, inflammation, and ALDH1A1-RA-RAR signaling in rats

[49] Giorgi VS, Da Broi MG, Paz CC, Ferriani RA, Navarro PA

Hepatotoxicity Warn patients and guardians that nausea, vomiting, abdominal pain, anorexia, diarrhea, asthenia, and/or jaundice can be symptoms of hepatotoxicity and, therefore, require further medical evaluation promptly [seeWarnings and Precautions (5.1)]

Circadian rhythm disorder can change the expression of clock genes, disrupt the normal cell cycle, and then directly promote the initiation of malignancy

Plasma carnitine insufficiency and effectiveness of L-carnitine therapy in patients with mitochondrial myopathy