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Notably, the enantiomer D-carnitine may exert hepatotoxic effects (89), underscoring the critical importance of compound-specific safety evaluation and reinforcing that only the biologically active L-isomer should be considered for therapeutic use in MASLD

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Overactive Thyroid (Hyperthyroidism) Some clinical evidence suggests that l-carnitine may improve symptoms of high thyroid hormones, such as rapid or pounding heartbeat, nervousness, and weakness [17]