are there different types of l-carnitine Acetyl vs L-Carnitine: 4 Key Differences – Momentous L - Carnitine Plus 20
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However, these adverse events did not appear to be related to supplementation and occurred at similar frequencies in both groups

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Jamali-Raeufy N, Alizadeh F, Mehrabi Z, Mehrabi S, Goudarzi M (2021) Acetyl-L-carnitine confers neuroprotection against lipopolysaccharide (LPS) -induced neuroinflammation by targeting TLR4/NFB, autophagy, inflammation and oxidative stress

Extracellular osmolarity of medullary cells may become more than four-fold that of isotonicity [50]