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Things like cold showers, extreme sports, car accidents, relationship problems, intense movies, business deals gone awry, exams and war zones

Valproic acid alters fatty acid metabolism, which can lead to serious toxicity including metabolic acidosis, increased ammonia in the blood, liver damage, pancreatitis, bone marrow depression (low platelets, red cells and/or neutrophils) and cerebral edema (brain swelling)

doi:10.1016/S0140-6736(10)61462-6

Therefore, before starting Acetyl-L-Carnitine HCl, it is important to discuss with your healthcare provider about any medications, supplements, or herbal products you are currently taking