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Typical for LCHAD deficiency is the increased risk for female heterozygous carriers to develop hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and acute fatty liver of pregnancy (AFLP) [135, 136]
Additionally, L-carnitine upregulates peroxisome proliferator-activated receptor (PPAR) (18), a key regulator in the liver inflammatory response and oxidative stress (19,20), which has been found to be involved in regulating the expression of CPT I (21)
doi: 10.1016/j.fsi.2017.07.058
He also resumed bodybuilding activities, training three times a week, and successfully lost 10 kg in the past 5 months
doi: 10.1001/jamapsychiatry.2018.1877 86 Van DalenJ
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