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It is important to note that PIONEER 3 was a larger trial than PIONEER 12 (1864 participants vs 1441 participants, respectively) and had a longer duration (78 weeks with 5 weeks of follow-up vs 26 weeks with 5 weeks of follow-up, respectively) [18]

Particularly, when Lys and Met levels were increased by 40% above the recommendations, fat in the breast and leg muscles was reduced by 35% and 27%, respectively, along with a corresponding decrease in AF [133]

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Obesity, diabetes, and liver disease in relation to cardiovascular risk

Additionally, carnitine may worsen symptoms of hypothyroidism