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The liver, brain, and kidneys synthesize L-carnitine from the amino acids lysine and methionine and distribute the molecule throughout the body

Keeping that in mind, the next chart summarizes what ALA might help with, based on the strength of human clinical evidence

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L-carnitine supplementation increased sperm motility and improved pregnancy rates

And malic acid offers health benefits of its own, protecting both cardiometabolic health13 and the balance of beneficial microbes in the gut.14 For this reason, we believe that L-citrulline DL-malate supplements offer greater benefits than L-citrulline on its own

However, in 2019, they only budgeted 15 million dollars towards ME/CFS research, whereas 111 million dollars and 94 million dollars was donated to MS and RA research, respectively (both of which already have drugs on the market)