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One thing that could cause this decline is a decrease in blood flow through your body, a process called intermittent claudication

M.BhambhaniV.CushmanM.NayorM.et al (2018)

Analysis of differential transcriptional profiling in wheat infected by Blumeria graminis f

Absolute contraindications Pregnancy and breastfeeding Age under 21 Impaired kidney function Uncontrolled hypothyroidism / active thyroid hormone therapy (caution, consultation) Concomitant use of oral coumarin anticoagulants without INR control Hypersensitivity to L-carnitine or solution components Legal status The status of injectable L-carnitine is two-tiered: the molecule is widely approved orally, but the injectable form and its route of administration are subject to a separate framework