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The appetite effect comes partly from the brain, not just the stomach

Its not uncommon to begin treatment at age 50

doi: 10.1002/jsfa.11820 36 GiorgioV.MieleL.PrincipessaL.FerrettiF.VillaM

In patients with chronic kidney disease, reduced reabsorption of carnitine can affect the availability of carnitine in muscles, leading to skeletal muscle atrophy and decreased exercise endurance [262]

10.1016/j.biopha.2020.111021 141 LiY.YuX.DengL.ZhouS.WangY.ZhengX.et al (2021b)

Clozapine-induced reduction of l-carnitine reabsorption via inhibition/down-regulation of renal carnitine/organic cation transporter 2 contributes to liver lipid metabolic disorder in mice