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Eur J Pharm Biopharm 100:6676

This phenomenon may be due to saturation of L-carnitine transport into skeletal muscle at physiological L-carnitine plasma concentrations (4060 mol/l) and/or by the significantly higher carnitine concentration in skeletal muscle relative to plasma, rendering passive transport impossible [24]

doi: 10.3892/ijo.2015.3084 83 WeinbergRA

Because the effect is systemic, it also reduces fat in the faces natural subcutaneous compartments, leading to the deflated look that patients describe as Ozempic face