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In 1963, a breakthrough came with the discovery that NAD+ is a co-substrate for the addition of poly-ADP-ribose to proteins (Chambon et al., 1963)

[] However, the therapeutic mechanism of L-carnitine has not been characterized

10.1016/j.bcp.2017.12.004 177 WuQ.GeX.GengZ.WuH.YangJ.CaoS.et al (2024b)

If fever, chills, or other unexpected systemic reactions occur during an injection, it is likely due to the drug being delivered or possible contamination, rather than the bacteriostatic water itself

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The standard protocol is weekly injections