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However, they also state that there is little evidence to support this recommendation

The damage doesnt happen slowly and invisibly it can be seen in blood tests as elevated AST and ALT liver enzymes, long before any symptoms show up

doi: 10.1093/nar/gkae973 Summary Keywords atheroscelrosis, cholesterol metabolism, acetyl-L-carnitine (ALC), SREBP2, HMGCR Citation Xing J, Du Z, Li F, Wang Y, Zhang Z, Gao X, Han L, Sun X, Sun H, Du Y, Hu C, Yu H and Qin Y (2024) Acetyl-L-carnitine ameliorates atherosclerosis in LDLR / mice by modulating cholesterol metabolism through SREBP2-dependent cholesterol biosynthesis