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Name: acetyl-l-carnitine side effects cancer L-carnitine ameliorates the muscle wasting of cachexia through the AKT/FOXO3a/MaFbx axis | Nutrition & Metabolism Clinical Significance of Carnitine in
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Prog Neurobiol 62:583631 Chen G-D, Kermany MH, DElia A, Ralli M, Tanaka C, Bielefeld EC, Ding D, Henderson D, Salvi R (2010) Too much of a good thing: long-term treatment with salicylate strengthens outer hair cell function but impairs auditory neural activity

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While this specific trial was limited by a small sample size and high dropout rates (which impacted the statistical significance between the placebo and active groups), larger ongoing trials, such as a 310-patient study (NCT05703074), are currently underway to rigorously test NR's ability to combat physical and cognitive fatigue