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It is normally conjugated by glutathione (GSH), but when taken in excess, the body's glutathione reserves are not sufficient to deactivate the toxic NAPQI

For example, patients with systemic primary carnitine deficiency (SPCD) have a deficiency in carnitine due to a mutation in the plasma membrane sodium-dependent high affinity carnitine transporter (OCTN2) that enables cellular carnitine uptake in the heart, muscle, and kidney

Symptoms Warranting Medical Evaluation Persistent vomiting, significant dizziness, tachycardia, or chest discomfort after a peptide injection should prompt medical evaluation regardless of the suspected agent

doi:10.1002/jbmr.4709 Douaud G, Refsum H, de Jager CA, et al

Beyond memory, the Y-maze test also provided insights into the zebrafishs propensity for exploration and anxiety-like behaviors