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Patients and physicians have reported severe gastrointestinal complications involving persistent vomiting, severe nausea, abdominal pain, dehydration, malnutrition, and delayed stomach emptying that, in some cases, required hospitalization or emergency room treatment

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[Carnitine deficiency and carnitine therapy in a patient with Rett syndrome]

Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial

But note that this only solves the absorption issue, it doesnt solve the activation issue once it makes it into your body

Some owners also consider MSM in horses with poor hoof condition or respiratory allergies, although joint and recovery support are the most direct uses described here