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From a physiological point of view, the paracellular route and the transcellular endocytic route are the two relevant pathways in the context of the leaky gut

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Key points to consider when interpreting the evidence: Most studies are short-term , typically lasting fewer than 12 weeks, making it difficult to assess long-term efficacy or safety Results appear more pronounced in older adults or individuals with obesity, compared to younger, healthy populations L-carnitine alone, without dietary or lifestyle changes , is unlikely to produce clinically meaningful weight loss Neither NICE nor the NHS recommends L-carnitine supplementation as part of any weight management pathway