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To bypass this impenetrable barrier, the cell relies entirely on a three-step biochemical pathway known in medical literature as the carnitine shuttle

10.1016/0887-8994(86)90062-7 Camina MF, Rozas I, Castro-Gago M, Paz JM, Alonso C, Rodriguez-Segade S: Alteration of renal carnitine metabolism by anticonvulsant treatment

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A placebo-controlled trial of acetyl-L-carnitine and alpha-lipoic acid in the treatment of bipolar depression

ACH levels were measured by gas chromatography