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[8] L-carnitine has been reported to potentiate the anticoagulant effect of warfarin through unknown mechanisms, with case reports documenting supratherapeutic international normalized ratios after initiation of parenteral carnitine in malnourished adults

Higher levels of the amino acid homocysteine may be associated with a higher risk of heart attack and stroke

Research has also shown that people with higher levels of vitamin B12 are less likely to suffer from depression

If the deficiency goes untreated, severe neurologic effects may develop, so that the deficiency is clinically identified and treated early is very important