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Think about the example mentioned earlier relating to autism and carnitine deficiencies: the outcome of something like a gut infection or antibiotic use, can alter intestinal bacterial populations (in this case, increased propionic acid causing a carnitine deficiency)

Carnitine and type 2 diabetes

D., Sahebzeda, S

Acylcarnitine is more stable and less reactive than acyl-CoA and is an ideal form for storing activated acyl groups that can be transferred to CoA and provide a direct source of energy via FAO

Relevantly, many patients tend to receive only a partially efficacious treatment due to lack of awareness of the disorder.112,113 Thus, all patients with CVS are recommended to have an individualized treatment plan for improving results (Table 3).114 Treatment protocol for patients diagnosed with CVS in the emergency room CVS: Cyclic vomiting syndrome