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The literature reports that carnitine can promote the excretion of excess organic or fatty acids in patients with defects in fatty acid metabolism and/or specific organic acidopathies that bioaccumulate acylCoA esters.1-6 Secondary carnitine deficiency can be a consequence of inborn errors of metabolism

The cyclic form is the product of nucleophilic attack by the oxygen of a hydroxyl group on the electrophilic carbon of the carbonyl group within the same molecule, producing a stable ring structure composed of five or six carbons that minimizes bond strain (Figure 24.21 "Fischer Projection and Haworth Projection of Glucose")

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