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[Ref] Other Very common (10% or more): Pain (35%), flu syndrome (29%), chest pain (15%), accidental injury (12%), asthenia (12%), fever (12%) Common (1% to 10%): Peripheral edema, weight decrease, weight increase Very rare (less than 0.01%): Body odor, International Normalized Ratio (INR) increased [Ref] Local Very common (10% or more): Injection site reaction (38%) [Ref] Musculoskeletal Musculoskeletal side effects, in chronic hemodialysis patients, for levocarnitine (the active ingredient contained in L-Carnitine) in relation to placebo therapy have included asthenia (8% to 12% vs 8%) and leg cramps (4% to 8% vs 13%)

If your veterinarian recommends lab work or a diet change, treat that as the foundation