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The Koeth findings established a biologically plausible mechanism and a population association, but the human cardiovascular evidence on supplemental L-carnitine is mixed some carnitine trials report neutral or even favorable cardiovascular markers, particularly in cardiac and metabolic patient populations

Acetyl L-Carnitine can cross the blood-brain barrier effectively due to its acetylated form, which makes the molecule more lipophilic (fat-soluble)

Some studies have also explored how carnitine supplementation affects insulin sensitivity, which can be relevant for people managing insulin resistance, blood sugar fluctuations, cardiovascular health, or metabolic conditions

On the other hand, the classification of high- and moderate-intensity exercise performance could not be fully adjusted as a function of the criteria