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To reduce the risk of gastrointestinal side effects, a gradual escalation of doses is recommended

Long-term treatment with recombinant insulin-like growth factor (IGF)-I in children with severe IGF-I deficiency due to growth hormone insensitivity

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However, this strategy is only attractive if the therapeutic agent itself is not a substrate for CPA, or if the case, that its functional activity is not negatively affected by C-terminal cleavage

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[1] [2] [3] [4] Currently, there are no recommended NIH daily values for carnitine since your body can produce most of it on its own in the kidney and liver, then stores it in muscle, heart, and brain cells