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Insulin resistance also reduces free carnitine levels [28, 29], further impairing mitochondrial energy production

In the subgroup analysis on route of L-carnitnine supplementation, three studies supplementing L-carnitine orally (47 participants) demonstrated a significant lower odds of dialysis-related hypotension comparing L-carnitine to placebo (pooled OR = 0.03, 95% CI [0.0010.96], p = 0.04, I 2 = 88.3%) while 5 studies supplementing L-carnitine intravenously (177 participants) failed to reveal a difference in incidence of dialysis-related hypotension between these two groups (pooled OR = 0.51, 95% CI [0.251.06], p = 0.07, I 2 = 42.7%) (Table 3)

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Lets take a look at how this process takes place, including some of the genes/enzymes involved

Berg, J.L