ACS: acute coronary syndrome AF: atrial fibrillation ALC: acetyl- L -carnitine ASCVD: atherosclerotic cardiovascular disease ATP: adenosine triphosphate BCAAs: branched-chain amino acids CAD: coronary artery disease CKD: chronic kidney disease CPT: carnitine palmitoyltransferase DRIs: Dietary Reference Intakes ER: endoplasmic reticulum F/B: Firmicutes-to-Bacteroidetes FMOs: flavin monooxygenases FNB: Food and Nutrition Board GPLC: glycine propionyl- L -carnitine GSH: glutathione HF: heart failure IL-6: interleukin 6 LC: L -carnitine LC-MS/MS: liquid chromatography-tandem mass spectrometry MACE: major adverse cardiac events MAFLD: metabolic-dysfunction-associated fatty liver disease MDA: malondialdehyde MI: myocardial infarction NAFLD: non-alcoholic fatty liver disease NF-B: nuclear factor kappa-light-chain-enhancer of activated B cells PH: pulmonary hypertension SCD: sudden cardiac death SCFAs: short-chain fatty acids SYNTAX: Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery T2D: type 2 diabetes T2DM: type 2 diabetes mellitus TC: total carnitine TCA cycle: tricarboxylic acid cycle TMA: trimethylamine TMAO: trimethylamine- N -oxide HSW: Conceptualization, Writingoriginal draft, Writingreview & editing, Supervision, Validation

Missed doses should not be doubled
Preclinical studies in rodents showed that supplementation with high doses of acetyl-L-carnitine (ALCAR
The use of BCAA to decrease delayed-onset muscle soreness after a single bout of exercise: a systematic review and meta-analysis
Post-Exertional Malaise (PEM): By optimizing aerobic metabolism and preventing the rapid shift to anaerobic glycolysis, this supplement helps reduce the accumulation of lactic acid in muscles, potentially raising the threshold for exertion and minimizing the severity of post-activity crashes
Myth 4: Liquid L-Carnitine is unsafe Liquid forms are safe when manufactured under quality standards and consumed within dosage limits