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Your body produces carnitine from lysine and methionine, but synthesis can fall short during intense exercise, caloric restriction, aging, or in people who consume minimal red meat and dairy (the primary dietary sources)

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Our findings that tirzepatide has the highest risk of nausea and diarrhea, dulaglutide and lixisenatide the lowest, and exenatide the highest vomiting risk with dulaglutide showing a lower risk, are consistent with a recent meta-analysis reporting higher diarrhea risk for tirzepatide (risk ratio 1.812.18) than semaglutide (1.661.80) versus placebo, as well as trial data showing elevated nausea with tirzepatide and higher vomiting with exenatides short-acting formulation (Karagiannis et al., 2024)