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This variability adds a layer of uncertainty to dosing in hepatic impairment

During the PN stage, free carnitine levels were consistently higher in those babies who received the supplement, and the recovery in plasma levels occurred faster in those babies with higher gestational age

It plays a key role in fatty acid metabolism by facilitating the transport of long-chain fatty acids from the cytosol into the mitochondria, where they can then undergo beta-oxidation to produce energy

This is why stopping the medication during the early adjustment period (often the first month or two), when side effects are at their worst, often means missing the window in which the body would naturally adapt