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This naturally occurring substance is found in all mammalian tissues, especially striated muscle, and is required in energy metabolism, such as the oxidation of fatty acids, facilitating the aerobic metabolism of carbohydrates, and enhancing the excretion of certain organic acids

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A meta-analysis of creatine supplementation in the elderly concluded that creatine enhanced muscle mass, strength, and functional performance during resistance training [54]

Those with seizure disorders should be especially cautious, as acetyl-L-carnitine may potentially increase seizure frequency in susceptible individuals

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262 In one study, migraine sufferers were found to have significantly higher levels of nitrate, nitrite and nitric oxide reductase bacterial genes in samples collected from the oral cavity, and slight but significant differences in faecal samples as well