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[22] Osteoporosis and Bone Health Osteoporosis is more common in women with Hashimotos and thyroid conditions who take thyroid medications, as thyroid hormones speed up bone turnover

There's no lock-in period, though continuing your current medication dose may ease the transition

Hypersensitivity Reactions Serious hypersensitivity reactions, including anaphylaxis, laryngeal edema, and bronchospasm have been reported following levocarnitine administration, mostly in patients with end stage renal disease who are undergoing dialysis

If you want a deeper dive into this category, What is the Best Form of Glutathione