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Furthermore, L-carnitine upregulates genes involved in fatty acid transport and mitochondrial -oxidation ( Octn2, Cpt1a, Cpt2, Acadm ) while increasing metabolites associated with TCA cycle, urea cycle, and antioxidant pathways (malate, citrulline) (45)

The most common consequences are impaired vascular permeability, cardiac malfunction, and MDF leading to impaired respiration [27]

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10.1371/journal.pone.0031211 46 El-AnsaryA.BjrklundG.KhemakhemA

However, the quality, potency, and purity of multivitamins can vary a great deal