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[9] [10] [8] The Shuttle's mechanism is as follows: Carnitine palmitoyltransferase I, (CPT I) transfers the LCFAs from Coenzyme A (CoA) to the hydroxyl group of the carnitine (from translocase in step 2) to make acyl-carnitine

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Goal: Amplify endogenous GH/IGF-1 secretion through dual GHRH and ghrelin-receptor pathways [3]

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In addition, to be included in the sample, it was required that each patient spontaneously reported fatigue and chose to receive oral L-carnitine supplementation for 7 weeks, resulting in N = 52 for hypothyroidism (17% of patients) and N = 16 for CFS (all patients)