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The manufacture and handling of such dosage forms has so far been much more difficult due to the high hygroscopicity of L-carnitine

Administration of lipoic acid (200 to 1,800 mg/day for 2 weeks to 1 year), alone or together with other nutrients, was found to lower fasting blood glucose and insulin concentrations, insulin resistance, and blood HbA1c concentration a marker of glycemic control over the past few months (60)

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The diagnosis is usually made after an incidental discovery of unexplained elevation of liver enzyme levels or when steatosis is noted on imaging (e.g., ultrasonography)