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In the blood, once secreted from the pineal gland, melatonin is usually bound to albumin, metabolized to 6-hydroxymelatonin by cytochrome P-450 isoforms and conjugated, in the liver, to produce the principal urinary metabolite, 6-sulfatoxy-melatonin, which is finally eliminated through the kidney 14
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Minimal side effects have been reported, and may include nausea, abdominal cramps, and diarrhea[6] L-carnitine may increase the effects of blood thinners like Coumadin (warfarin) and Sintrom (acenocoumarol), causing excessive bruising or bleeding