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Total symptom score decreased significantly compared to placebo across treatment groups of all doses 600-1800 mg/d oral ALA, yet there was a dose-dependent increase in nausea, vomiting, and vertigo, and therefore the lowest dose of oral ALA (600 mg/d) is recommended

Therefore, it appears that long-term supplementation is a required before effects become apparent

That said, it is helpful to monitor thyroid and carnitine levels when taking L-carnitine not because problems are expected, but because monitoring is good clinical practice when adding any supplement that has a theoretical interaction pathway

Indeed, one alternative hypothesis, that CVS is associated with dominantly-inherited brain neurotransmitter receptor genes, was evaluated in parallel and found to have a far fewer (and highly statistically significant) Key and total Qualifying variants among the gene lists