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Another mechanism by which melanocortin receptors (mainly MC3R and MC4R) appear to express anti-inflammatory impact is a cholinergic anti-inflammatory pathway through the vagus nerve and alpha-7 receptors

[Link] Accordingly, our results indicate that ALCAR is transported from blood to brain ECF by OCTN2 at least in part, and its concentration in brain ECF is regulated by other events such as protein binding and anabolic reactions in the brain, as well as by transport across the BBB. Reuter, SE and Evans, AM, Carnitine and acylcarnitines: pharmacokinetic, pharmacological and clinical aspects. in Clinical Pharmacokinetics , Volume 51, Issue 9, pp 553 - 572

These are the kinds of metabolic shifts that dramatically reduce cardiovascular risk and extend healthspan