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According to animal studies, berberine could bring some unintended negative consequences for intestinal microbes

10.1016/j.jhep.2017.11.026 68 LeeC

This decline in grip strength occurred independently of body weight, indicating that endothelial IGF- 1R signaling plays a critical role in maintaining muscle force generation, potentially through vascular contributions to muscle function rather than direct muscle atrophy

There are a few other types of L-carnitine (ex: Acetyl L-carnitine) Carnitine is important for optimal brain function and energy production in the body and may protect against some chronic diseases

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GHRH activates GHRH receptors using cAMP-dependent PKA signaling