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Carnitine uptake by the liver depends on relatively high carnitine concentration in the blood, since carnitine enters the liver through OCTN2 (organic cation transporter 2), a carrier with high Km (Michaelis-Menten constant) for carnitine (Km = 5.6 mM: Christiansen and Bremer, 1976 ), thus the liver takes carnitine from the blood when its concentration is significantly rised
Impairment of excretion of AC occurs with deteriorating renal function leading to decreased carnitine clearance and resulting in elevated plasma levels of carnitine [13]
While more research is still needed to see how well this works in humans, early studies are promising
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