L carnitine is primarily synthesized in the liver from the amino acids lysine and methionine through a series of four enzymatic reactions, with the liver and kidneys converting the precursor butyrobetaine into active Putative role of BCAA and l carnitine treatments in cirrhotic liver. A Download Scientific Diagram The Role of l Carnitine in Mitochondria, Prevention of Metabolic Inflexibility and Disease Initiation The Importance of the Fatty Acid Transporter L Carnitine in Non Alcoholic Fatty Liver Disease (NAFLD)