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Practical dosing protocol Based on the available evidence, a reasonable protocol for combining semaglutide with L-carnitine looks like this: The injection component: Use the compounded semaglutide/L-carnitine formulation according to the standard semaglutide titration schedule Inject subcutaneously once weekly at the standard injection sites (abdomen, thigh, or upper arm) Follow the same injection technique as standalone semaglutide The oral supplement component (optional but recommended for full dosing): 500 to 2,000 mg L-carnitine or acetyl-L-carnitine daily Taken with meals for better absorption Start at 500 mg daily and increase as tolerated Morning dosing is preferred as L-carnitine may cause restlessness if taken late in the day Monitoring schedule: Weight and body composition assessment every 4 to 6 weeks Lipid panel and HbA1c every 3 months Liver function tests at baseline and 6 months Energy and fatigue assessment at each check-in Use the semaglutide dosage calculator to determine your exact semaglutide dose, then discuss L-carnitine addition with your prescribing provider
