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Andersson, Emmanuel Shapira, Biochemical and clinical response to hydroxocobalamin versus cyanocobalamin treatment in patients with methylmalonic acidemia and homocystinuria (cblC), The Journal of Pediatrics, Volume 132, Issue 1, January 1998, Pages 121-124, ISSN 0022-3476, Okuda K, Yashima K, Kitazaki T, Takara I

Another study [44] with uremic patients with some degree of muscular atrophy, reports that 24-week treatment with l-carnitine (2 g IV at the end of hemodialysis, or in dialysis solution, or per os twice daily) leads to an increase of about 7% in the diameter of type I and type IIa fibers, as well as to a reduction in atrophic fibers

25(8):1904 Tavakoli J, Miar S, Majid Zadehzare M, Akbari H (2012) Evaluation of effectiveness of herbal medication in cancer care: a review study

Some users have also described emotional flattening, reduced motivation and lower sexual desire while using the drugs