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2015;33(1 Suppl 88):S82-5

More specifically, the present invention relates to a process for preparing L-carnitine or acetyl L-carnitine hydrochloride, comprising sequentially synthesizing racemic 4-chloro-3-hydroxybutyronitrile of Formula 2 and racemic 4-chloro-3-hydroxy butyric acid alkyl ester of Formula 3 under specific reaction conditions, using racemic epichlorohydrin of Formula 1 as a starting material, preparing (R)-4-chloro-3-hydroxy butyric acid alkyl ester of Formula 4 from stereoselective hydrolysis of the racemic 4-chloro- 3 -hydroxy butyric acid alkyl ester in an aqueous solution using an enzyme, and preparing L-carnitine of Formula 6 or acetyl L-carnitine hydrochloride of Formula 7 from the (R)-4-chloro-3-hydroxy butyric acid alkyl ester

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(2022) 77:S681

A recent study suggested that plasma levels of 5-MT, a compound related to serotonin metabolism, may be decreased in CFS patients, but this has been interpreted as a confounder caused by serotonin-selective reuptake inhibitor (SSRI) use in these patients ( The principal role of carnitine is to transport long-chain fatty acids into the mitochondria for energy production via beta-oxidation (53)