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L-carnitine plays a vital role in the -oxidation of long chain fatty acids (LCFAs) to produce energy by transporting LCFAs from the cytosol into the mitochondrial matrix, and can modulate the ratio of acetyl-CoA/CoA 3,4
Conversely, if the medication freezes, the proteins can clump, leading to cloudiness or particles
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therefore, to achieve health benefits, the patient's individual needs must be considered ( According to IKDSG guidelines, KD use is strictly contraindicated in patients with a deficiency of carnitine (primary), carnitine palmitoyltransferase (CPT) 1 or 2, carnitine translocase, pyruvate carboxylase, medium-chain acyl-coenzyme A (CoA) dehydrogenase (MCAD), long-chain acyl-CoA dehydrogenase (LCAD), short-chain acyl-CoA dehydrogenase (SCAD), and disorders of fatty acid -oxidation and porphyria
Disadvantages: Because nasal absorption is highly dependent on mucosal health, airflow, and technique, the same dose may not yield consistent results from patient to patient, or even for the same patient on different days
