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Lets look at some common factors that lead to carnitine deficiency in adults: Causes of deficiency Inadequate Carnitine Intake due to unbalanced meals, excessive junk food, or fad diets Lack Of Enzymes that are necessary for the metabolism of carnitine Hereditary Disorder is characterized by renal leakage of carnitine through the tubes Decreased production due to some liver disorder Loss of Carnitine due to gastrointestinal disturbance such as diarrhea, diuresis, or hemodialysis Mitochondrial impairment leads to low carnitine levels in muscles Deficiency symptoms L Carnitine deficiency can lead to various signs and symptoms due to its vital role in energy metabolism

Prog Mater Sci 83:270329

Biological Pathways Linking Metabolic Disease and Cancer Mechanistic research suggests that obesity and T2D often lead to a state of chronic, low-grade inflammation and, crucially, sustained hyperinsulinemia (excessively high insulin levels)

It says patients may not see the expected appetite suppression, weight loss, or blood glucose improvement because less active drug is delivered

Since tirzepatide and retatrutide both affect GLP-1-related pathways, similar caution may apply