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Without adequate carnitine, long-chain fatty acids cannot enter the mitochondrial matrix and remain unavailable for energy production regardless of lipolysis

Dietary modifications (highest impact for most people): Mercury : Reduce high-mercury fish : Avoid or minimize swordfish, shark, king mackerel, tilefish, bigeye tuna

In one case, a distinct enzyme has evolved via convergent evolution, or nonorthologous displacement, that catalyzes exactly the same reaction

When to seek medical advice : Call 999 or go to A&E immediately if you experience chest pain, signs of stroke, severe allergic reaction, or significant bleeding