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This transesterification is catalyzed by an enzyme found in the outer membrane of the mitochondria known as carnitine acyltransferase 1 (also called carnitine palmitoyltransferase 1, CPT1)

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Ann N Y Acad Sci 2004 , 1033 , 3041 [13] Zeiler, F.A

Patients should be counseled to report concerning symptoms such as neck swelling, difficulty swallowing, persistent hoarseness (potential thyroid issues), or severe abdominal pain, persistent vomiting, or right upper quadrant pain (potential pancreatitis or gallbladder issues)