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The down-regulation response to adenosine is not mediated through G-protein-coupled adenosine receptors, but occurs through an increase in tyrosine protein phosphatase activity resulting in a decrease in the tyrosine phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) mitogen activated protein kinase (MAPK) that leads to an alteration in DPP4 mRNA

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But there is a distinct difference between carnitine and acetyl L carnitine in their structures and specific functions

If you experience lingering side effects, consult your provider before increasing the dose further