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Most importantly, it facilitates the transport of long-chain fatty acids into the mitochondria for use in ATP production

In addition, the accumulation of acylcarnitine in the pathological state of the liver leads to insulin resistance, which further aggravates the development of liver diseases and results in a vicious cycle [211]

Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review

doi: 10.1016/0014-2999(95)00442-N

The US National Kidney Foundation did not recommend routine administration of L-carnitine to subjects undergoing dialysis yet encouraged the development of trials in patients with select symptoms that do not respond to standard therapy, i.e., persistent muscle cramps or hypotension during dialysis, severe fatigue, skeletal muscle weakness or myopathy, cardiomyopathy, and anemia requiring large doses of erythropoietin (74, 75)