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There is some indirect evidence to suggest that excess lysine in the diet may increase endogenous L-carnitine synthesis

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Certain health conditions such as intestinal or stomach problems, poor nutrition, cancer, HIV, pregnancy, old age, veganism, and alcoholism can cause vitamin B12 deficiency

Despite the benefits, potential side effects should be considered

Triptolide induced spermatogenesis dysfunction via ferroptosis activation by promoting K63-linked GPX4 polyubiquitination in spermatocytes

Another article looked at acetyl-l-cysteine and Clomid in women with unexplained infertility