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Some protocols use site-specific injections near the injury for more localized effects, though systemic absorption still occurs

Breast-associated adipocytes secretome induce fatty acid uptake and invasiveness in breast cancer cells via CD36 independently of body mass index, menopausal status and mammary density

However, subclinical deficiency affects between 2.5% and 26% of the general population depending on the definition used, although the clinical relevance is unclear

PMID: 32274669

"The effects of L-carnitine supplementation on glycemic control: a systematic review and meta-analysis of randomized controlled trials." National Library of Medicine

In the United States, capsaicin is available over-the-counter in a variety of forms, but in concentrations no greater than 0.25% (Drugs.com 2020)