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Individuals on certain medications : Medications like proton pump inhibitors, metformin, or H2 receptor antagonists can interfere with B vitamin absorption

Kajstura J, Cheng W, Reiss K et al (1996) Apoptotic and necrotic myocyte cell deaths are independent contributing variables of infarct size in rats

Increased Energy & Reduced Fatigue B12 is involved in red blood cell production and energy metabolism

The covalent interactions involving hydrogens were constrained using SHAKE algorithm

Therefore, we are cautious in drawing a conclusion regarding the beneficial effects of L-carnitine on the quality of life of patients with covert HE, which was the primary endpoint of this study.Our study had some limitations