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If you experience nausea, muscle weakness, or metabolic stalling despite adherence, discuss stopping the supplement with your provider
Pivalate is a branched-chain fatty acid anion that is metabolized to form an acyl-CoA ester, which is transesterified to carnitine and subsequently excreted in the urine as pivaloyl carnitine
doi: 10.1053/j.jvca.2006.11.017 131 GuoCPanXDouMWuJChenXWangBet al
Standard capsules often have very low bioavailability, meaning much of the supplement is wasted during digestion
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