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At the extreme end of this situation, where there is a genetic deficit in carnitine biosynthesis, some nasty stuff happens without carnitine supplementation [1]: Liver damage and dysfunction Brain damage Muscle weakness Lethargy Exercise intolerance Yet, there can also be situations of mild deficiency where these overt signs arent present

Fat can accumulate again with weight gain, potentially requiring additional treatments

These changes are associated with increased cardiovascular and metabolic disease risk

doi: 10.1136/gutjnl-2017-314508