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Moreover, there may be significant gender and individual differences in carnitine metabolism, which may have important implications for its functions in physiological and pathological processes

[21] L-carnitine may also interact with thyroid hormone, potentially interfering with thyroid hormone action, and patients with thyroid conditions should use it cautiously under medical supervision

One user on Reddit mentioned, They do work

Usually it is a good enough indicator to compare different models from the same brand, but I would not compare C ratings of different brands with each other, or at least only see it as a ballpark range

The peptide appears to influence angiogenesis, the formation of new blood vessels, which is crucial for tissue repair processes