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Andrology 11(2):204214 Bhasin S, Brito JP, Cunningham GR, Hayes FJ, Hodis HN, Matsumoto AM et al (2018) Testosterone therapy in men with hypogonadism: An Endocrine Society Clinical Practice Guideline

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These mutations lead to inadequate levels of the enzyme, very long-chain acyl-coenzyme A dehydrogenase resulting in the accumulation of long-chain fatty acids and patients are unable to make ketone bodies for energy

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While carnitine supplements are not always able to reverse the effects of this deficiency, they have proven to be the most successful course of treatment