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 Hong Kong Journal of Paediatrics [HK J Paediatr (New Series) 2020;25:23 29] L Carnitine Side Effects & Risks Blood carnitine as a biomarker for acute myocardial infarction.
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