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However, most is produced in the liver when growth hormone levels increase in the blood
Increased GH levels enhance the rate at which proteins are synthesized in muscle tissue
In the TMLHE gene knockout mouse model, the carnitine biosynthetic pathway is inhibited due to the loss of TMLD activity in the liver, affecting the availability of carnitine in the heart, significantly reducing the rate of synthesis of LCACs, and contributing to the protection of mitochondrial function after myocardial IRI [215]
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The numbers below are from the published REDEFINE 1 and REDEFINE 2 papers and the Novo Nordisk FDA filing announcement