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It is worth noting that L-Carnitine in supplements can increase blood levels of trimethylamine-N-oxide (TMAO) over time, high levels of which are associated with a risk of atherosclerosis (clogging of the arteries)
The 2025 IV pilot measured cardiac, hepatic, renal, thyroid, and glucose biomarkers and reported no abnormalities (Lee et al., 2025), which gives a sense of what those investigators considered worth checking
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It doesnt mean that L-carnitine supplementation is unsafe, but it does reinforce the idea that more doesn't mean better
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