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Far more research is needed

Overdose may cause profound drowsiness, confusion, ataxia, hypotension, respiratory depression, metabolic acidosis, hyperammonemia, and in severe cases coma

Giampieri, M

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In addition to differences in the amino acids themselves, there are notable differences in the metabolic pathways, even in pathways in which the primary amino acid itself is not changed

Int J Cardiol 146:145152 Cui J, Das DK, Bertelli A, Tosaki A (2003) Effects of l-carnitine and its derivatives on postischemic cardiac function, ventricular fibrillation and necrotic and apoptotic cardiomyocyte death in isolated rat hearts