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[1] [3] Secondary carnitine deficiencies may happen as the result of certain disorders, such as chronic kidney failure, or under conditions that reduce carnitine absorption or increase its excretion, such as the use of antibiotics, malnutrition, and poor absorption following digestion

Moreover, it is not known if S-5-HT mediated the effects of L-carnitine on fatigue, as it is possible that L-carnitine could have effects unrelated to S-5-HT that could reduce fatigue and in parallel promote increased synthesis of peripheral 5-HT

11 th ed: Lippincott Williams & Wilkins
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Voor anderen kan het effect echter subtiel zijn en is het waarschijnlijk niet de belangrijkste factor bij gewichtsverlies