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*Current Opinion in Endocrinology, Diabetes & Obesity*, 24(6), 420-435

Patients using any formulation should select a time that fits naturally into their daily routine to maximise long-term compliance

Megaloblastic anemia, in which red blood cells are larger than normal and smaller in amount Pernicious anemia, a type of anemia caused by lack of intrinsic factor Numbness and tingling in the hands and feet Dementia Depression Seizures Fatigue Sore mouth or tongue Palpitations Pale skin Weight loss Infertility Some of these side effects, particularly nervous system side effects and psychiatric problems, can be irreversible if not treated promptly

The evidence for supplemental L-Carnitine improving weight loss in non-deficient individuals is weak, but it has a reasonable safety profile