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Chain length-specific properties of ceramides

The sister died of sudden cardiopulmonary arrest due to the increase of long-chain (C16-18) acylcarnitines

For example, in a randomized, double-blind, placebo-controlled trial in 60 participants diagnosed with an acute MI, neither mortality nor echocardiographic measures of cardiac function differed between patients treated with intravenous L-carnitine (6 g/day) for seven days followed by oral L-carnitine (3 g/day) for three months and those given a placebo (49)

Secondary genetic carnitine deficiency CPT-1 deficiency Carnitine palmitoyltransferase I (CPTI) deficiency is thought to cause serious disorders of fatty acid metabolism

The addition of the acetyl group makes the molecule more lipophilic (fat-soluble), allowing it to interact uniquely with specialized transport proteins in the body, fundamentally changing where it can go and what it can do once it gets there

Factors required for Carnitine synthesis more details