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The balance between acetyl-CoA and coenzyme A (or CoA) is determined by L-carnitine, which is instrumental in the conversion of acetyl-CoA to acetyl-L-carnitine, which can be then dissipated out of the mitochondria, thus avoiding the accumulation of acyl groups inside the mitochondria, which could be toxic

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However, another randomized, double-blind, placebo-controlled trial in 181 patients with diabetic neuropathy found that oral supplementation with either 600 mg/day, 1,200 mg/day, or 1,800 mg/day of lipoic acid for five weeks significantly improved neuropathic symptoms (77)

Hypoglycemic and lipid lowering effects of theaflavins in high-fat diet-induced obese mice