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This transport role mediated by the carnitine palmitoyltransferase (CPT-I/CPT-II) enzyme system is L-carnitine's central and most extensively documented mechanism, making it a foundational molecule in research on fatty-acid metabolism and mitochondrial energy production

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Symptoms and Types Signs of this deficiency may include: Lethargy Muscle pain Exercise intolerance Enlarged heart (dilated cardiomyopathy) Heart muscle failure L-carnitine is important for muscle tissue to receive energy and function normally

The trade-off is that this only works under tightly controlled conditions: an empty stomach, no more than a small sip of plain water, and nothing else taken alongside it