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Total and free carnitine levels are often reduced with higher-than-normal levels of acylcarnitine so that the acylcarnitine to free carnitine ratio is increased ( CPT II gene, which cause either truncation of the protein or degradation of its mRNA, are associated with LNF of CPT II deficiency ( Alternatively, the diagnosis can be made by detecting decreased CPT II enzyme activity in cultured fibroblasts ( CPT II c.63dup (p.Ser 22Glnfs*37), inherited from both parents

However, I typically tell patients if they have gotten absolutely no benefit after the 2 nd round that we should move on to another treatment option

This is because the molecule is broken down in the small intestine and the individual components then reach the liver via the bloodstream

Psychiatry 34 , 746747 (1993)

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