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The severe form of VLCADD can cause cardiomyopathy, enlarged liver, rhabdomyolysis (muscle breakdown), and hypoglycemia

It can also vary widely depending on the type of procedure or the location of the hospital, but the cost of treatment in India is generally much more affordable than in Western countries

doi: 10.3390/nu13041297

Rather, the majority of orally ingested l-carnitine in mice produced a previously unappreciated intermediary metabolite, -butyrobetaine (BB), in a gut microbiotadependent step that occurred at a site anatomically proximal to, and at a rate 1,000-fold higher than the rate of the formation of TMA (26)

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