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People should also seek medical treatment if they have a canker sore that significantly impairs their ability to eat, drink, or speak

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A recent study suggested that plasma levels of 5-MT, a compound related to serotonin metabolism, may be decreased in CFS patients, but this has been interpreted as a confounder caused by serotonin-selective reuptake inhibitor (SSRI) use in these patients ( The principal role of carnitine is to transport long-chain fatty acids into the mitochondria for energy production via beta-oxidation ( While carnitine supplementation could have benefits, some recent studies suggest that chronic oral L-carnitine administration may be associated with an increased risk for atherosclerosis via increased trimethylamine (TMA) and/or trimethylamine N-Oxide (TMAO) levels ( Mitochondrial dysfunction has been suggested to contribute to CFS ( The mechanisms that link carnitine intake, S-5-HT, and fatigue, in both CFS and hypothyroidism, are yet unknown

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