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If symptoms persist or become severe, it is important to consult your healthcare provider to discuss adjusting your titration schedule
Neurochem Res 15:597601 Ricciolini R, Scalibastri M, Kelleher JK, Carminati P, Calvani M, Arduini A (1998) Role of acetyl-l-carnitine in rat brain lipogenesis: implications for polyunsaturated fatty acid biosynthesis
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Other etiologies, such as metformin-induced lactic acidosis and infection, were ruled out with additional testing (a lactic acid level of 1 mmol/l, no signs of acute pancreatitis in CT scan, no signs of pneumonia in a chest X-ray)
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