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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
Delays in diagnosis and subsequent initiation in treatment of pernicious anaemia have been shown to increase the risk of irreversible neurological damage involving both the central and peripheral nervous system, resulting in permanent symptoms, such as peripheral neuropathy, cognitive impairment and damage to the spinal cord (known as subacute combined degeneration of the spinal cord)[9,16]
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