is l-carnitine hard on the kidneys and Chronic Kidney Disease: A Comprehensive Review Nutrition and Health Perspectives L-Carnitine damages your kidneys —

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These are known as "ketone bodies" and the process as "ketogenesis", and they are readily transported to extrahepatic tissues and converted back to acetyl-CoA, which then enters the citric acid cycle and is oxidized in mitochondria for energy (ATP production)

Carnitine Palmitoyltransferase (CPT1) activates the conversion of carnitine and long chain acyl-CoAs to form long chain acetylcarnitine (most often acetylcarnitine) and Coenzyme A which can effectively pass into the inner regions of the mitochondia

J Clin Invest (2019) 129:37387

Does Vitamin D deficiency play a role in peripheral neuropathy in Type 2 diabetes