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When people have a lot of reactions to different supplements, its usually a liver issue

Interestingly, although L-carnitine content was comparable between the low-dose and high-dose L-carnitine groups (Figure 2), the counteracting effect of L-carnitine on protein expression was, at least partly, greater in the high-dose group than in the low-dose group (Figure 3)

it binds cardiolipin, stabilizes the inner mitochondrial membrane, and prevents cytochrome c leakage, thereby reducing apoptosis and maintaining mitochondrial potential (216)

Similarly, acarbose, which blunts postprandial glucose spikes by inhibiting carbohydrate digestion, addresses one of the specific mechanisms by which perimenopausal glucose dysregulation manifests