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Semaglutide and Levocarnitine

Mar 28, 2024
Semaglutide and Levocarnitine

As research into weight loss continues to evolve and medications are discovered that stretch the success boundaries of previous generations of weight loss medications, there is interest in combining weight loss medications like semaglutide and levocarnitine (L-carnitine) that work via different mechanisms of action (MOAs). The potential benefits include a synergistic effect on weight loss, but the drawbacks include increased costs and an increased risk of side effects.

Semaglutide is an approved medication that has been proven to be very effective in treating obesity and type 2 diabetes. Levocarnitine is a naturally occurring amino acid that plays a critical role in converting fat into energy. Semaglutide + levocarnitine has the potential to increase weight loss and energy levels by facilitating fat metabolism.

There is not a lot of research or data on using a semaglutide L-carnitine combination, but there is research on their independent effects on weight loss.

Semaglutide: An Approved Weight-Loss Medication

Semaglutide is a weekly injectable drug that mimics your body’s naturally produced glucagon-like peptide 1 (GLP-1) and binds to receptors in the brain, stomach, pancreas, and gut. Your intestines secrete GLP-1 after you eat.

When semaglutide binds to GLP-1 receptors found throughout your body, it has the following potential benefits:1

  • Increases insulin secretion from the pancreas to reduce blood glucose levels.
  • Reduce glucagon release to stabilize blood sugar levels.
  • Slows stomach emptying, so you feel full longer.
  • Reduces hunger and increases satiety levels.
  • Reduces food noise, a condition that leads to mindless eating and food cravings.

Many people who struggle with maintaining a healthy body weight report that food noise is a major issue. They think about food all day. Seeing food on the counter, smelling food, or even hearing a bag crinkling can cause intense cravings for high-fat, high-salt foods.

In the Semaglutide Treatment Effect in People with Obesity (STEP) clinical trials, people taking semaglutide lost an average of 14.9% to 17.4% of their body weight over 68 weeks, a substantially higher weight loss than people using diet and exercise alone in the placebo arms of the trials.2


Levocarnitine, also known as L-carnitine, is a naturally occurring amino acid produced in the body from methionine and lysine. It helps usher fats into the mitochondria (little power-producing organelles in your cells), where they can be used for energy. In a review of weight loss studies, researchers found that levocarnitine did not lead to significant weight loss, but the GLP-1 agonists, like semaglutide, were among the most effective.3

Levocarnitine is also obtained through the diet (mainly animal products) since the body cannot produce enough to meet its needs. In most people, fish, meat, and dairy products supply at least 80% of the necessary levocarnitine, and the body produces the rest. Most healthy people, including vegetarians, are able to meet their levocarnitine needs through their diet.

Supplementing with levocarnitine can reduce liver and blood lipid levels and reduce fat deposits in the liver. This can make weight loss easier if it is a result of consuming a high-fat diet.4

BMI measurements

The Benefits of Combining Semaglutide and Levocarnitine

Semaglutide compounding pharmacies can prepare compounded semaglutide as long as the medication remains on the FDA drug shortage list. Compounding pharmacies are specialized facilities that prepare custom-made medications containing semaglutide. The compounding pharmacist creates a customized medication for an individual patient based on the healthcare provider’s prescription.

Because compounded semaglutide is prepared for individual prescriptions or in small batches, it can be customized to a patient’s needs. Semaglutide commonly causes gastrointestinal (GI) side effects such as nausea, vomiting, diarrhea, and constipation, especially when the medication is first started or the dose is increased.

Because of these known and common side effects, many prescriptions for compounded semaglutide also include B12, B6, or levocarnitine. These nutrients are thought to reduce nausea (B vitamins), increase energy levels (B12, B6, and levocarnitine), and support weight loss.

The Semaglutide and Levocarnitine Treatment Plan

To optimize the benefits of semaglutide and levocarnitine or semaglutide and B12, you will need a prescription from a healthcare provider and a personalized treatment plan. Start the process with a consultation with an Invigor Medical licensed healthcare provider who will assess your medical history, lifestyle, and weight loss goals. Based on this assessment, they will create a tailored treatment plan. Regular monitoring and support from the healthcare team will ensure that your weight-loss journey is on track and adjustments can be made as needed.

Infographics Semaglutide

Potential Side Effects and Safety

As with any medication, both semaglutide and levocarnitine have the potential to cause side effects.

The most common semaglutide side effects (>2%) in semaglutide clinical trials are:

  • Nausea
  • Diarrhea
  • Vomiting
  • Constipation
  • Abdominal pain
  • Headache
  • Fatigue
  • Dyspepsia
  • Dizziness
  • Gas
  • Low blood sugar in people with type 2 diabetes
  • Gastroenteritis
  • Gastroesophageal reflux disease
  • Hair loss
  • Burning skin and nerve sensitivity

Levocarnitine, when taken in appropriate doses, is generally well tolerated with minimal side effects.

The most common levocarnitine side effects include:

  • Stomach cramps
  • Diarrhea
  • Headache
  • Nausea
  • Vomiting
  • Weakness
  • Muscle aches
  • Allergic reactions and itching

Some people, depending on their medical and family history, are at an increased risk for side effects from semaglutide and levocarnitine. Talk to your doctor about your medical history to get a good understanding of your benefit-risk profile for these medications.

A pharmacist preparing compounded semaglutide.

Cost Considerations

Of the two medications, semaglutide and levocarnitine, semaglutide has the highest barrier in terms of cost and access. The GLP-1 medications, liraglutide, semaglutide, and tirzepatide, remain on the FDA shortage list. Compounding pharmacies can help fill the current supply-and-demand gap.

About half of all U.S. adults have asked their doctor about prescription weight-loss medications. About 93 million people meet the eligibility criteria for taking semaglutide (body mass index (BMI) of 30 or higher, or 27 or higher with a weight-related medical condition).5

If you meet the criteria for taking a GLP-1 agonist, such as semaglutide, start a weight loss treatment plan request through Invigor Medical. After you complete your medical forms, you will meet with a licensed healthcare provider on the Invigor Medical platform to see if you are a good candidate for semaglutide or another weight loss medication.

Integrating Semaglutide and Levocarnitine into a Healthy Lifestyle

While Semaglutide and Levocarnitine can significantly aid in weight loss, it is important to remember that they are not standalone solutions. Incorporating these treatments into a healthy lifestyle that includes a balanced diet and regular exercise will yield the best results and help you maintain your weight loss when you stop taking the medications. Consulting with a registered dietitian and fitness professional can provide additional guidance and support in creating a sustainable weight loss plan.

Frequently Asked Questions

Which works better for weight loss: semaglutide or levocarnitine?

In clinical trials, semaglutide is very effective in suppressing appetite, normalizing blood sugars, and inducing weight loss. Levocarnitine can support these benefits.

Can you get levocarnitine in your diet?

Yes, levocarnitine is found in red meat, poultry, fish, and dairy products. Your body can also produce levocarnitine. However, some people cannot make enough or do not consume enough L-carnitine in their diet, causing symptoms. Some medications may also deplete L-carnitine.

What are the most common side effects of semaglutide and levocarnitine?

Both semaglutide and levocarnitine can cause gastrointestinal symptoms such as nausea, vomiting, stomach cramping, and diarrhea.

How do Semaglutide and Levocarnitine work together for weight loss?

Semaglutide helps control appetite and glucose levels, while Levocarnitine may enhance fat metabolism.

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

Semaglutide and Levocarnitine

Leann Poston, M.D.

Dr. Leann Poston is a licensed physician in the state of Ohio who holds an M.B.A. and an M. Ed. She is a full-time medical communications writer and educator who writes and researches for Invigor Medical. Dr. Poston lives in the Midwest with her family. She enjoys traveling and hiking. She is an avid technology aficionado and loves trying new things.


  • Wadden TA, Bailey TS, Billings LK, Davies M, Frias JP, Koroleva A, Lingvay I, O’Neil PM, Rubino DM, Skovgaard D, Wallenstein SOR, Garvey WT, Investigators S. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA. 2021;325(14):1403-1413.
  • Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obes Metab. 2023;25(1):18-35.
  • Shi, Q., Wang, Y., Hao, Q., Vandvik, P. O., Guyatt, G., Li, J., Chen, Z., Xu, S., Shen, Y., Ge, L., Sun, F., Li, L., Yu, J., Nong, K., Zou, X., Zhu, S., Wang, C., Zhang, S., Qiao, Z., … Li, S. (2022). Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. Lancet, 399(10321), 259–269.
  • Alhasaniah AH. l-carnitine: Nutrition, pathology, and health benefits. Saudi J Biol Sci. 2023 Feb;30(2):103555. doi: 10.1016/j.sjbs.2022.103555. Epub 2022 Dec 30. PMID: 36632072; PMCID: PMC9827390.
  • Mozaffarian D. GLP-1 Agonists for Obesity—A New Recipe for Success? JAMA. 2024;331(12):1007–1008. doi:10.1001/jama.2024.2252


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