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Six months into the study, 4 patients in the control group and 2 patients in the carnitine group had obvious encephalopathy (II), but there were no significant differences between the groups

That is signalling some thing is wrong, despite blood results being good/erroneous

For serious or severe symptoms (such as swelling of the face, lips, tongue or throat, difficulty breathing or swallowing, dizziness, or collapse): Call 999 immediately or go to your nearest Accident & Emergency (A&E) department

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Gastrointestinal Tolerability and Escalation Considerations To minimize GI symptoms, dose titration should be gradual and closely monitored, particularly in elderly or frail patients

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