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Certain medications can deplete natural L-carnitine levels and potentially cause carnitine deficiency: Pivalate-conjugated antibiotics such as pivampicillin Anticonvulsants such as valproic acid, phenobarbital, phenytoin, and carbamazepine If youre taking one of these prescriptions, ask your healthcare provider if L-carnitine supplementation might be right for you

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For example, hepatotoxicity may be amplified not only by 17-alkylated oral steroids but also by concomitant use of other hepatically metabolized agents, alcohol, contaminated or counterfeit products, and high-dose supplements (93, 95)

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The uneven surface of the tibia and femur condyles restricted the joint space