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The answer is: it has shown anti-aging effects in animal models, but not yet in humans

In a 2003 study, acetyl-L-carnitine protected against the neuropathy commonly caused by cisplatin and paclitaxel, two frequently used chemotherapy drugs.29 In similar studies in 2005, daily treatment with acetyl-L-carnitine produced improvement in 73% of patients,30 as well as significantly better sensory and motor scores.27 Both groups of investigators recommended further testing and suggested that acetyl-L-carnitine has a role in both preventing and treating chemotherapy-induced neuropathy

For most patients, it will be supplements (if I had to pick one)