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15 Because serum methylmalonic acid level is as sensitive as, but more specific than, serum homocysteine level for vitamin B 12 deficiency, it is the confirmatory test of choice

Some individuals experience temporary changes in mood or affect, with occasional reports of mild dysphoria, emotional lability, or paradoxically increased anxiety in a small subset of users, though others report mood improvement and reduced anxiety individual variability in response appears substantial

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Taken by mouth, only a relatively small fraction of L-carnitine actually makes it into your bloodstream studies put oral bioavailability at roughly 1418%, and it drops further at higher doses