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T., Jafarinia, M., Esalatmanesh, S., & Akhondzadeh, S

The gut microbiota and CVDs The human gut is colonized by approximately 100 trillion microorganismsincluding beneficial bacteria, neutral bacteria, and pathogenic bacteriawhich cooperate to maintain homeostasis of the gut microecology (11)

[158] found increased activity of choline acetyltransferase and expression of nerve growth factor (NGF) receptor in the striatum, and increased NGF protein levels in the hippocampus of rat pups after intracerebroventricular injection of ALCAR every other day from 021 days of age

Prolonged submaximal exercise and l-carnitine in humans

The diagnosis is established by demonstrating abnormally low plasma free carnitine concentrations, reduced carnitine transport of fibroblasts from skin biopsy, and molecular analysis of the gene coding for OCTN2 (33, 34)

2017 meta-analysis: A systematic review and meta-analysis of nine randomized controlled trials showed that ALCAR supplementation significantly decreased depressive symptoms compared to placebo (standardized mean difference 1.10, 95% CI 1.65 to 0.56), with effects comparable to established antidepressants like fluoxetine, particularly in older adults or those with treatment-resistant depression [5][30]