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When PAD progresses to the advanced disease stage, the ischemic injury becomes more severe, manifesting as rest pain, chronic ulceration, gangrene, and finally loss of tissue

J Androl 19(4):434443 Lefivre L, Jha KN, de Lamirande E, Visconti PE, Gagnon C (2002) Activation of protein kinase A during human sperm capacitation and acrosome reaction

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By facilitating removal of potentially toxic acyl groups and stabilizing cellular membranes, levocarnitine may support metabolic flexibility and protects against accumulation of organic acids