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The metabolism of VPA can be affected by numerous factors including genetic variability in CYP450 enzymes, inborn errors of metabolism, concomitant use of other medications, malnutrition and inhibition of normal metabolic pathways during acute poisoning

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These deficiency forms explain the accumulation of fats at the muscle level (within muscle cells) with severe effects on the normal activity of skeletal muscle

Gut microbiota and ischemic stroke: The role of trimethylamine n-oxide

In one example of a physiological response to osmotic pressure, in early mammary gland milk production osmoregulatory pathways are exploited using asymmetric kinetics to increase the carnitine concentration in milk for suckling neonates who have reduced carnitine stores, even though this results in decreased maternal liver stores [20]