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[Ref] Hematologic Very common (10% or more): Anemia (12%) [Ref] There have been reports from clinical trials of significant increases in platelet aggregation associated with high doses of levocarnitine (3 g/day) given to hemodialysis patients

That said, the company states that it processes returns on a case-by-case basis and that theres some leeway in certain scenarios

These include regulation of mechanisms controlling reactive oxygen species (ROS), which cause macromolecular damage 16,17 , mitochondrial turnover or mitophagy 18 , and the mitochondrial unfolded protein response (UPR mt ), in which mitochondrial damage can be prevented by the removal of aggregated or unfolded proteins 19

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Scand.J Clin Lab Invest 1985;45(3):193-198

No long-term safety or efficacy data exists