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Another cause is a diet that is low in L-Carnitine-rich foods, such as red meat and dairy products

Intense abdominal pain that feels different from typical bloating. Signs of an allergic reaction, such as hives or swelling

STEP 1 [5] (Wilding et al., NEJM , 2021) Supplementary Appendix

Starting doses are conservative and titrated upward every 4 weeks based on tolerance and response

Two 2013 systematic reviews of interventions concluded that the modest benefit of propionyl-L-carnitine on walking performance was equivalent or superior to that obtained with drugs approved for claudication in the US (e.g., pentoxyphylline, cilostazol) yet inferior to improvements seen with supervised exercise interventions (69, 70)