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In one placebo-controlled, double-blind study of 66 centenarians that's right, people age 100 and over who reported fatigue even after slight physical activity, all 32 who received 2g of l-carnitine per day (as opposed to 34 receiving a placebo) demonstrated significant improvements in total fat mass (-1.8kg average vs +.6kg), total muscle mass (3.8kg average compared with 0.8kg), physical fatigue, mental fatigue, fatigue severity, and performed better on a mental state examination

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Key elements include asking about pain severity using validated scales, documenting functional impact, and assessing cyclical symptom patterns