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In vitro, C16-carnitine has been found to activate specific subsets of neurons in the dorsal root ganglia (DRGs) of muscles that play a key role in sensing muscle fatigue or exertion and are involved in transmitting these sensory signals to the CNS, indicating that C16-carnitine acts as a signaling molecule for muscle afferent nerves [281]
This metabolic penalty persists for years and makes maintaining weight loss without pharmacological support extraordinarily difficult
Randomisation in these trials was prospectively stratified by baseline background medication, which can be considered a strength of the current analyses
Some studies suggest the peptide may remain viable beyond that window, but 28 days is the conservative standard most protocols follow
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