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You note that patients are mixed on their satisfaction with currently available HS treatments, and these patients often have concurrent conditions

At this time, it appears that there is no need to cycle L-carnitine

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Neeland, Linge, and Birkenfeld (2024), writing in Diabetes, Obesity and Metabolism , conclude that skeletal muscle changes with GLP-1 receptor agonist treatment appear adaptive: reductions in muscle volume are commensurate with what is expected given aging, disease status, and weight loss achieved, and improvements in insulin sensitivity and muscle fat infiltration likely contribute to improved muscle quality

It is essential to work with a qualified provider for proper dosing, timing, and follow-up