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One way that regulatory agencies monitor the safety of drugs post-approval is through systems where patients and doctors can voluntarily report adverse events possibly related to a drug or medical device

Despite evidence indicating incr levels of free carnitine and carnitine metabolites in the blood and urine following an oral dose, no significant change in RBC carnitine levels was noted in healthy subjects, suggesting either a slow repletion of tissue stores of carnitine following an oral dose or a low capability to transport carnitine into tissues under normal conditions

Achieving new milestones in workouts (e.g., lifting slightly heavier, completing more reps)

Endotoxins are biologically active