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These can include nausea, vomiting, diarrhea, constipation, abdominal discomfort, reflux, and reduced appetite

It is a carnitine specific transporter that disappeared during evolution: it is present in mouse, but not in chimpanzee or humans (Pochini et al., 2013)

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Patients who chose GLP-1 therapy may differ from matched controls in ways that affect bone density independently of the medication, though propensity matching was used to control for known confounders

But the downsides are also obvious

Exogenously delivered acetyl-l-carnitine is endowed with neuroprotective and neurotrophic actions due to its antioxidant and metabolic properties