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Pharmacodynamics Several molecular mechanisms are responsible for the pharmacological effects of acetyl-l-carnitine and are extensively reviewed in Sarzi-Puttini et al

In particular, in a RCT in women with PCOS with BMI 25 kg/m 2 and/or insulin resistance, Frssing et al

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It blocks NNMT , an enzyme that wastes niacin (NAM) and methyl groups, so your cells keep more NAD for mitochondrial upkeep and more SAM for healthy methylation

Bilirubin binding to research-subject liver ligandin (glutathione S-transferase)

And FDA regulators agreed, saying later that the substances present significant safety risks, because most have not been extensively tested in humans