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Common indicators include: Fatigue and Weakness: Persistent tiredness and low energy are often the first signs of low vitamin D

According to the National Institutes of Health, though most individuals do not need to make an extra effort to eat foods high in carnitine , some genetic or medical problems (such as angina or intermittent claudication) and certain drugs can prevent the body from producing enough of the nutrient, resulting in a shortage

But new research presented in late 2025 suggests that when it comes to actual, sustained weight loss in real-world patients, surgery still outperforms these medications by a wide margin

Drug Targets 13 , 285293 (2012)