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306). This is likely due to decreased digestive enzyme production or decreased stomach acid resulting in a decreased ability to cleave B12 from its carrier proteins in animal foods

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The US National Kidney Foundation did not recommend routine administration of L-carnitine to subjects undergoing dialysis yet encouraged the development of trials in patients with select symptoms that do not respond to standard therapy, i.e., persistent muscle cramps or hypotension during dialysis, severe fatigue, skeletal muscle weakness or myopathy, cardiomyopathy, and anemia requiring large doses of erythropoietin (74, 75)

Mechanism of Schwann cells in diabetic peripheral neuropathy: a review