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The nuance is that the body synthesizes carnitine and most people have adequate baseline carnitine levels from dietary intake (primarily from red meat) the supplemental benefit is most pronounced in vegetarians and vegans (who have significantly lower dietary carnitine intake), older adults (whose carnitine synthesis declines with age), athletes in high-volume training (who deplete carnitine more rapidly), and anyone in a caloric deficit where fatty acid oxidation demand is elevated relative to carnitine availability.

Kelley, D

Ca 2+ influx through AMPA or kainate receptors alone is sufficient to initiate excitotoxicity in cultured oligodendrocytes

Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM et al (2020) Global burden of cardiovascular diseases and risk factors, 19902019