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As the most debilitating symptoms, depressive state, and chronic fatigue occur in a majority of patients with MS and NMO ( Various factors can affect the level of carnitine in vivo

[38] The results of a recent study regarding L-carnitine supplementation for the management of fatigue in patients with hypothyroidism found that L-carnitine may be useful in alleviating fatigue symptoms in hypothyroid patients, especially in those younger than 50 and those who have hypothyroidism due to a thyroidectomy

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Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit, selected frailty biomarkers (interleukin-6, tumor necrosis factor-alpha, and insulin-like growth factor-1), physical function, cognitive function, nutritional status and biochemical profile