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A major barrier lies in distinguishing between prognostic, predictive, and surrogate endpoint biomarkers

A small pilot study in nondiabetic subjects at cardiovascular risk found that one gram of ALCAR twice daily for 24 weeks improved glucose disposal rates in those who were most insulin-resistant at baseline

L-carnitine and acetyl-L carnitine are also amino acids chemically-related to propionyl-L carnitine in fact, the body can convert L-carnitine to propionyl-L carnitine and acetyl-L carnitine

Figure 2 illustrates how these interventions map onto the immunometabolic pathways: e.g., scavenging mtDNA, inhibiting inflammasomes, boosting mitophagy, providing healthy mitochondria, and improving immune cell metabolism at various points in the cascade