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Yet this effect is more pronounced and common with Acetyl-L-Carnitine

Notably, the study observed changes in acyl-carnitine levels after 8 weeks of treatment, indicating potential metabolic responses to therapy

Harald, O

Studies of human SHBG regulation have revealed cis -acting elements in the human SHBG proximal promoter that interact with members of the nuclear hormone receptor (NHR) family, including HNF4 and COUP-TF that compete for an imperfect NHR DR-1 (direct repeat-1) element located about 20 bp upstream of the transcription start site, and act as the main stimulators and repressors of SHBG expression in liver cells, respectively 8

Mitochondrial carnitine palmitoyl transferase system (Virmani et al.,2015) 4
doi: 10.1128/iai.12.2.252-256.1975
