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This possibility should always be looked at

Does oral L-carnitine alter plasma triglyceride levels in hypertriglyceridaemic subjects with or without non-insulin dependent diabetes mellitus

doi: 10.1007/s00404-023-07200-8 81 CielikMBagiskaNGrskiAJoczyk-MatysiakE

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Mutations in RNF170, ERLINs, or IP 3 R are implicated in neurological disorders, including ataxias and spastic paraplegias

You may need a stronger concentration of HQ possibly six, eight, or 10 percent