l carnitine and metabolism The system cancer metabolic plasticity Possible metabolism of acetyl-l-carnitine (ALCAR)

For those who want strong effects quickly, IV might be the way to go

N Engl J Med 382:727733

In 39 randomized double-blind, placebo-controlled (RDP) human clinical trials including 2,009 subjects, Pycnogenol French maritime pine bark extract supplementation for two weeks to six months has been shown to beneficially affect cardiovascular health, chronic venous insufficiency, cognition, joint health, skin health, eye health, womens health, respiratory health and allergies, oral health and sports performance

The documented ladder is stepwise for a reason, and the safest response to a plateau is patience at the current step, not a jump