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Carnitine deficiency impairs a variety of metabolic processes in the liver, including lipid metabolism, gluconeogenesis, ketogenesis, albumin biosynthesis, and ammonia detoxification in the urea cycle [201], and carnitine/acetylcarnitine supplementation can ameliorate a variety of liver diseases [202, 203]

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The exception to that is found, however, in many disease states (including hyper- and hypo-thyroid states), as well as in conditions relating to specific types of diets (high-fat, high-protein, and low-carb)

Penn D, Zhang L, Bobrowski PJ, Quinn M, McDonough KH: Carnitine deprivation adversely affects cardiac performance in the lipopolysaccharide- and hypoxia/reoxygenation-stressed piglet heart

Y-YM and X-HZ provided assistance for data analysis and performed the experiments