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L-Carnitine forms a reversible ester bond with fatty acids, creating acylcarnitine, which is then transported across the inner mitochondrial membrane by specific carrier proteins

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Thus, as circulating L-carnitine concentration increases (as after high-dose intravenous or oral administration of L-carnitine), efficiency of reabsorption decreases and clearance increases, resulting in rapid decline of circulating L-carnitine concentration to baseline