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Administration of exogenous carnitine is thought to decrease ammonia levels by binding to VPA, thereby enhancing the -oxidation process and production of acetyl-CoA, and relieving the inhibition of urea synthesis

The risk is much higher in men and women with gonadal dysgenesis, specially forms that arise from early gonadal differentiation defects, such as mutations in SRY and WT1, than in individuals with ovotesticular DSD or with hormone synthesis or action disorders (for example, androgen insensitivity) [168,169,170]

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There is no clinical evidence that injection timing affects efficacy

Citation on PubMed Lehmann D, Motlagh L, Robaa D, Zierz S

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