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The distribution of carnitine stores needs to be considered for the interpretation of the clinical significance of serum carnitine levels in disease states, especially when the steady state is disturbed acutely or after supplementation of Lcarnitine orally or intravenously (IV)

Fourteen reported subjective improvement, but there was no control group, no blinded assessment, no objective functional endpoint and no follow-up imaging endpoint [5]

Conflict of interest The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper

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Special populations requiring careful consideration include pregnant and breastfeeding women, elderly individuals with reduced kidney function, and cancer patients