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Both as a patient and healthcare provider it is important to understand the mechanism of action to maximize its benefits while minimizing potential pitfalls

In older children or adults it may be considered if there are clinical symptoms suggestive of carnitine deficiency (hypotonia, lethargy), a significant decrease in the serum free carnitine levels, an impairment in hepatic function tests, or hyperammonaemia, even in the absence of VHE

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10.1016/j.freeradbiomed.2012.10.555 31 LiuP.WangY.YangG.ZhangQ.MengL.XinY.et al (2021)

But they should not be the only path offered, and never the standard of success

Whats happening: Sleep architecture is shifting