L carnitine is primarily synthesized in the liver from the amino acids lysine and methionine through a series of four enzymatic reactions, with the liver and kidneys converting the precursor butyrobetaine into active Frontiers Fatty acid oxidation in immune function The Role of l Carnitine in Mitochondria, Prevention of Metabolic Inflexibility and Disease Initiation Fatty Acid Metabolism Concise Medical Knowledge Carnitine Acetyltransferase an overview ScienceDirect Topics The Importance of the Fatty Acid Transporter L Carnitine in Non Alcoholic Fatty Liver Disease (NAFLD)