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A review published in Regulatory Toxicology and Pharmacology stated that the evidence of safety is strong at intakes up to 2000mg/day l-carnitine equivalents for chronic supplementation. The authors went on to note that taking higher levels had not shown any safety risks

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This resulted in recurrent emesis and low appetite, with a consequent 45-kilogram (100 lbs) weight loss from a baseline of 158.8 kg (350 lbs), and a seven-point reduction in glycated hemoglobin from a baseline of 14% over the course of ten weeks