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While there is no scientific evidence supporting the need for cycling L-Carnitine, some individuals choose to do so

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Five patients discontinued treatment due to lack of efficacy or unwillingness to continue

Higgins JP, Green S: Cochran Handbook for Systematic Review of Interventions: Assessing Risk of Bias in Included Studies

Gut microbes can use carnitine and acylcarnitine as carbon sources, nitrogen sources, osmotic protectants or electron acceptors, but the gut microbiota cannot synthesize carnitine itself, and the mitochondrial function of acylcarnitine produced by carnitine palmitoyltransferase has not been observed in prokaryotes [230]

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