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[8] Absolute contraindications include prior hypersensitivity to cyanocobalamin, cobalt, or formulation excipients

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Obesity is associated with low-grade systemic inflammation, characterized by increased levels of inflammatory markers such as Toll-like receptor 4 (TLR4), tumor necrosis factor-alpha (TNF-), IL-6, IL-1 [36], IL 17, leptin [37], and resistin [38]

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The study did not measure the L-carnitine excretion from urine before and after the intervention, which might provide further explanation of L-carnitine distribution inside the human body