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Monitoring is recommended with Tesamorelin

Although NEFA and TG were not significantly influenced by l-carnitine supplementation under these experimental conditions, further research must clarify whether net TG synthesis might be responsible for this increase in leptin

Yes and its actually encouraged

Curr Neuropharmacol 2021;19:1202-24

Preference weights and willingness-to-pay (or affordable cost thresholds) should be validated across diverse socioeconomic and healthcare-access contexts, so that decision tools do not inadvertently encode the values and constraints of resource-abundant settings

People with kidney disease or seizure disorders should exercise particular caution with L-carnitine supplements or energy drinks that contain it