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A small percentage of patients report persistent loose stools, which may indicate a need for dose adjustment or dietary modification rather than medication discontinuation

Med 38(11):602606 Gallwitz B (2019) Clinical Use of DPP-4 Inhibitors

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L-carnitine does not directly cause insomnia, but it may: Delay sleep onset Reduce deep sleep if taken late Increase restlessness in sensitive users This is more likely if: Taken at night Taken in high doses Combined with other stimulants Best Time to Take L-Carnitine (For Better Sleep) Recommended Timing Morning (empty stomach) best for fat metabolism Pre-workout boosts energy and endurance Avoid Late evening Just before bedtime If sleep quality is your priority, avoid L-carnitine 46 hours before sleep

In contrast, oxidative stress, DNA damage, or inflammatory stress responses were not activated