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Synthesized primarily in the human liver and kidneys from the essential amino acids lysine and methionine, L-carnitine relies on a complex cascade of cofactors for its production, including Vitamin C, Vitamin B6, niacin, and iron

The putative mechanisms for the ameliorating effects of synbiotics on glycemic status principally mediated through amplifying SCFA production could be considered as four principal issues, namely, ameliorating glucose homeostasis, attenuating insulin resistance, amending gut integrity, and hindering proinflammatory signaling pathways (61)

To the best of our knowledge, this study is the first study of its kind that was conducted to investigate the effects of the L-carnitine supplement on frailty status either among the frail or prefrail elderly

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Further clinical studies are required to establish the usefulness of L-carnitine supplementation in hypothyroidism (see Table 1 )