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However, like any supplement, some people may experience mild side effects especially when starting out or taking high doses: Nausea or stomach upset: most common, usually passes after the first week Diarrhea or loose stools: reduce dose if this happens Fishy body odour: reported by some users, especially at high doses Headache: mild and temporary in some cases Restlessness or difficulty sleeping: avoid taking it late in the evening Safety Note: The European Food Safety Authority (EFSA) has declared L-carnitine safe at doses up to 3,000 mg/day for healthy adults

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Further development continued in the HERMIONE Phase II trial, although clinical success was constrained by tumor heterogeneity and variability in HER2 expression