The L-carnitine injections from Citizen meds have been phenomenally effective for my chronic fatigue. They really work! I’m shocked because I’ve tried so many other things to combat fatigue that haven’t (thyroid hormones, testosterone replacement, NAD+ pills and injections, B12 injections, B vitamins, alpha lipoic acid, etc). After learning that chronic fatigue/fibromyalgia patients often have low carnitine levels due to low carnitine transporters and and poor dietary absorption on ChatGPT and that carnitine is essential for your cells mitochondria to be able to use their primary energy source, fat, I decided to give it a try.

The IM injections seemed a bit intimidating but once you get the knack, it’s all good. I do wish the instructional video was clearer though. On the video, it appears as though the injection is going into the top of the thigh, but thigh IM injections should be injected into the top of the side of the thigh or vastus lateralis, not the direct top. The injection didn’t burn or sting and to my surprise caused no aches, soreness, or pain after, something I could not say for ReviveRx, which their carnitine injections burned like fire and caused a painful ache so bad, I was limping, despite being a big name compounding pharmacy that you’d expect to have a quality product. Upon closer inspection of both labels, I learned that Citizen likely buffers their Carnitine with NaOH to achieve an isotonic or near-physiologic pH which is critical for comfortable IM injection. The low concentration of 100 mg/mL and levocarnitine they use rather than cheaper L-carnitine HCl form than Revive used also explains why Citizen Meds’ carnitine injections don’t burn. I’m very impressed and give much kudos to Citzen Meds for designing a comfortable and patient-friendly formulation of carnitine. Because it doesn’t burn the muscle, it seems to absorbs better and faster and so you feel the energy much more than Revive’s formulation—at least for me. And the energy boost is not like caffeine or a stimulant. There is no energy “jolt.” It feels very natural. It’s almost subtle in that sense but it’s also dramatic because it’s so stark from my constant fatigue before. Instead of a caffeinated energy, it’s an “I feel like I’m 18 again” kind of an energy. Just like I can do what I need to do and feel great doing it, and I don’t feel tired until nighttime before bed, when I’m supposed to be. Otherwise, I’m running on all cyclinders.

The only real problem I have with Citizens is the dose provided given the price. Through ChatGPT, I learned that the standard dose for fatigue is usually 350 mg-1,000 mg per day given 2-3 times per week (usually about 500 mg/dose) and most online wellness clinics offer a 5,000 mg vial for the same price or lower than Citizens is offering for only a 1,000 mg vial, usually between $80-$170…but I learned the hard way that Citizens is using a much better quality product than the cheaper “L-carnitine HCl form” that burns like the dickens, and this justifies a higher price point somewhat, but not that high. Even with a profit margin for Telehealth and then using the higher caliber product, patients should at least be getting 2,500-3,000 mg for a vial, which would allow for a more normal fatigue dose.

Even if you subscribe and save $40ish, you’d still only get maybe 1/3 the amount of what you’d likely get from your local compounder who can compound the same high caliber isotonic formulation of L-carnitine, though of course, it may be harder to find a compounder who uses the cleaner isotonic formula over the cheap, L-carnitine buffered with hydrochloric acid that is very acidic and burns muscle.

Of course, Citizens has to make a profit too but for that tiny of a dose, the markup is just unacceptable and I will unfortunately have to find somewhere else who can do it more affordably. If Citizens supplied a more reasonable dose given the price, I’d stay right here and have no reason to switch, as the med works. No debates there.

Consistent with the dose actually needed to treat fatigue, I felt a small boost at the prescribed 100 mg (maybe 20%), but it wasn’t until I took 350 mg that I really felt a large, life-altering difference my fatigue, (75-80% improvement)—but that is ~ 1/3 of the vial, and would be far too expensive to maintain long-term with Citizens without buying multiple vials each month which would get very pricey.

I’m also not a fan of the forced expensive ($22) expedited shipping. While I appreciate the fast shipping, customers should really have an option to choose between standard of expedited—like most Telehealth and other online services provide. I wouldn’t advertise expedited shipping as a “perk” if customers are forced to pay for it and can’t even opt out. Perk usually implies a savings or complementary benefit—not being forced to pay for overpriced shipping.

Lastly, while the package came quickly and was very well packaged, and I love that everything you needed comes neatly presented in a box with their name on it and with needles and alcohol swabs, I’m one of those people that reads the side effects/contraindications before I start any injectable or medication, and this didn’t come with any. Maybe that’s because it’s an amino acid and not a traditional medicine, I’m not. Either way, patients should be provided with something to know what to expect.

Customer service is phenomenal. Professional, quick, and responsive whenever I reached out. The dose provided is just too low given the price and far below the usual recommended dose for fatigue given the price. I would recommend Citzens do some pricing research on L-Carnitine and aim for a more competitive price range to better retain customers without changing their high caliber formula because it works. But I am still giving 3.5 stars solely because the product actually works as advertised, which is rare, and it actually reduces fatigue when taken at the dose shown in research to actually reduce fatigue. If they improved the dose offered for the price, I would become a long-time subscribing customer and adjust my review to 5 starts to reflect the change.

The L-carnitine injections from Citizen meds have been phenomenally effective for my chronic fatigue. They really work! I’m shocked because I’ve tried so many other things to combat fatigue that haven’t (thyroid hormones, testosterone replacement, NAD+ pills and injections, B12 injections, B vitamins, alpha lipoic acid, etc). After learning that chronic fatigue/fibromyalgia patients often have low carnitine levels due to low carnitine transporters and and poor dietary absorption on ChatGPT and that carnitine is essential for your cells mitochondria to be able to use their primary energy source, fat, I decided to give it a try.

The IM injections seemed a bit intimidating but once you get the knack, it’s all good. I do wish the instructional video was clearer though. On the video, it appears as though the injection is going into the top of the thigh, but thigh IM injections should be injected into the top of the side of the thigh or vastus lateralis, not the direct top. The injection didn’t burn or sting and to my surprise caused no aches, soreness, or pain after, something I could not say for ReviveRx, which their carnitine injections burned like fire and caused a painful ache so bad, I was limping, despite being a big name compounding pharmacy that you’d expect to have a quality product. Upon closer inspection of both labels, I learned that Citizen likely buffers their Carnitine with NaOH to achieve an isotonic or near-physiologic pH which is critical for comfortable IM injection. The low concentration of 100 mg/mL and levocarnitine they use rather than cheaper L-carnitine HCl form than Revive used also explains why Citizen Meds’ carnitine injections don’t burn. I’m very impressed and give much kudos to Citzen Meds for designing a comfortable and patient-friendly formulation of carnitine. Because it doesn’t burn the muscle, it seems to absorbs better and faster and so you feel the energy much more than Revive’s formulation—at least for me. And the energy boost is not like caffeine or a stimulant. There is no energy “jolt.” It feels very natural. It’s almost subtle in that sense but it’s also dramatic because it’s so stark from my constant fatigue before. Instead of a caffeinated energy, it’s an “I feel like I’m 18 again” kind of an energy. Just like I can do what I need to do and feel great doing it, and I don’t feel tired until nighttime before bed, when I’m supposed to be. Otherwise, I’m running on all cyclinders.

The only real problem I have with Citizens is the dose provided given the price. Through ChatGPT, I learned that the standard dose for fatigue is usually 350 mg-1,000 mg per day given 2-3 times per week (usually about 500 mg/dose) and most online wellness clinics offer a 5,000 mg vial for the same price or lower than Citizens is offering for only a 1,000 mg vial, usually between $80-$170…but I learned the hard way that Citizens is using a much better quality product than the cheaper “L-carnitine HCl form” that burns like the dickens, and this justifies a higher price point somewhat, but not that high. Even with a profit margin for Telehealth and then using the higher caliber product, patients should at least be getting 2,500-3,000 mg for a vial, which would allow for a more normal fatigue dose.

Even if you subscribe and save $40ish, you’d still only get maybe 1/3 the amount of what you’d likely get from your local compounder who can compound the same high caliber isotonic formulation of L-carnitine, though of course, it may be harder to find a compounder who uses the cleaner isotonic formula over the cheap, L-carnitine buffered with hydrochloric acid that is very acidic and burns muscle.

Of course, Citizens has to make a profit too but for that tiny of a dose, the markup is just unacceptable and I will unfortunately have to find somewhere else who can do it more affordably. If Citizens supplied a more reasonable dose given the price, I’d stay right here and have no reason to switch, as the med works. No debates there.

Consistent with the dose actually needed to treat fatigue, I felt a small boost at the prescribed 100 mg (maybe 20%), but it wasn’t until I took 350 mg that I really felt a large, life-altering difference my fatigue, (75-80% improvement)—but that is ~ 1/3 of the vial, and would be far too expensive to maintain long-term with Citizens without buying multiple vials each month which would get very pricey.

I’m also not a fan of the forced expensive ($22) expedited shipping. While I appreciate the fast shipping, customers should really have an option to choose between standard of expedited—like most Telehealth and other online services provide. I wouldn’t advertise expedited shipping as a “perk” if customers are forced to pay for it and can’t even opt out. Perk usually implies a savings or complementary benefit—not being forced to pay for overpriced shipping.

Lastly, while the package came quickly and was very well packaged, and I love that everything you needed comes neatly presented in a box with their name on it and with needles and alcohol swabs, I’m one of those people that reads the side effects/contraindications before I start any injectable or medication, and this didn’t come with any. Maybe that’s because it’s an amino acid and not a traditional medicine, I’m not. Either way, patients should be provided with something to know what to expect.

Customer service is phenomenal. Professional, quick, and responsive whenever I reached out. The dose provided is just too low given the price and far below the usual recommended dose for fatigue given the price. I would recommend Citzens do some pricing research on L-Carnitine and aim for a more competitive price range to better retain customers without changing their high caliber formula because it works. But I am still giving 3.5 stars solely because the product actually works as advertised, which is rare, and it actually reduces fatigue when taken at the dose shown in research to actually reduce fatigue. If they improved the dose offered for the price, I would become a long-time subscribing customer and adjust my review to 5 starts to reflect the change.