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The identification of a distinct, non-IGF-1R MGF receptor remains an active research goal

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Two reports in cerebrospinal fluid analysis found equivalence between ME/CFS and control except for reduced mannose and acetylcarnitine in ME/CFS 19 and a hypometabolic profile with decreases in tryptophan, glutamate, butyrate, polyamine and tricarboxylic acid (TCA) cycle pathways in ME/CFS 20

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A unique but harmless side effect of high-dose L-carnitine is a "fishy" odor in the breath, sweat, or urine