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Thus, deficiencies in L-carnitine or its transporter CAC have particularly adverse effects on cardiomyocytes, resulting in cardiomyopathy, cardiac arrhythmia, cardiac insufficiency, and heart failure [4]

Here's NALT's structure, notice the additional Acetyl Group boxed in red

It works the same way mechanistically, activating the GLP-1 receptor to reduce appetite, slow gastric emptying and improve insulin sensitivity, but the small molecule structure means it can be taken orally with fewer absorption constraints. In trials, orforglipron lowered blood sugar and produced meaningful weight loss in people with obesity and in those with type 2 diabetes, says LaValle

doi: 10.1016/j.cmet.2018.04.010 140