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Peripheral Neuropathy Diabetic Neuropathy Guidelines from the American Society of Pain and Neuroscience (ASPN) state that, although dietary supplements including acetyl-L-carnitine may have a role in managing painful diabetic neuropathy, there is insufficient high-quality evidence comparing ALCAR to typical pharmacologic drugs, and there is not enough information about safe dosing, to recommend for or against its use [7][24]

Epilepsy Res 101:202209

Vitamin B12 deficiency causes tiredness, weakness, constipation, loss of appetite, weight loss, and megaloblastic anemia

The higher dose of ALC was non-significantly more effective than placebo

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