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The symptoms of levocarnitine deficiency may include muscle weakness (muscles of the hips, shoulders, neck, jaw, and even heart muscles), fatigue, low blood sugar, stomach pain, growth retardation, brain function defects, etc

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As hydrolysis reactions at high pH involve nucleophilic attack of hydroxide ions on the ester carbonyl group, it should not be surprising that other nucleophilic groups within the membrane are capable of participating in a similar attack to form a lysolipid ( 3 , Scheme 3) and a lipidated product, an amide in the case of an amine ( 4 ) or an ester should the nucleophilic group be an alcohol

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