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If there is no significant change in cholesterol, TG, and HDL-C levels, there will not be any changes in the LDL-C level.[ , ] However, supplementation with L-carnitine could probably decrease the LDL-C and TG levels by increasing the expression of the LDL-C receptor and LPL genes.[] The observed reduction in LDL-C levels may be due to the consumption of low-calorie diet and aerobic exercise along with the supplementation.[] Gonzlez-Ortiz et al

However, in patients with severe congenital heart disease, the initial dose of L-T4 should be reduced