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Other factors, including tobacco smoke, pollution, unbalanced diet, genetic inefficiencies, and use of prescription and/or over the counter drugs (most notably acetaminophen) can further compound this loss. From Centre dEnseignement et de Recherche en Nutrition (CERNh)
Instead, efforts were redirected to develop and assess an improved once-daily formulation aimed at enhancing the drug's tolerability and patient acceptance
for example, synthesis of the neuromuscular messenger and neurotransmitter acetylcholine (15, 16)
Endogenous synthesis cannot meet the demand, making them prone to L-carnitine deficiency
doi: 10.1111/j.1471-4159.2004.02617.x