These changes occurred after they received the methyl B12 injections
These include: Low levels of L-carnitine are associated with decreased brain and heart function, impaired muscle movement, and liver problems as well as tiredness and fatigue

Oral Administration Subcutaneous (SubQ) Injection Injected just under the skin, typically near the site of injury Best for targeted healing of tendons, ligaments, joints, and muscles Fast absorption and high local bioavailability Injection sites : Shoulder issues : Lateral deltoid, upper bicep Knee or patella tendonitis : Around the lower thigh or above kneecap Ankle or Achilles pain : Outer calf or above heel Elbow or wrist pain : Forearm or triceps area How to inject SubQ : Use an insulin syringe (2931G, inch) Pinch skin, insert needle at a 4590 angle Inject slowly, rotate injection sites daily Inject 12 inches away from direct injury to avoid tissue trauma Intramuscular (IM) Injection Less common, but can be used when injecting deeper tissues or larger muscles Administer into lateral deltoid, glutes, or vastus lateralis May increase discomfort
Hsieh M-J, Lee C-H, Chueh H-Y, Chang G-J, Huang H-Y, Lin Y, et al