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Fller M, Feil S, Ghoreschi K, Koka S, Gerling A, Thunemann M, et al
It can be further oxidized to N-methyl-2-pyridone-5-carboxamide (2PY) and N-methyl-4-pyridone-3-carboxamide (4PY) in vivo and is easily excreted in urine in the forms of MNA, 2PY, and 4PY (in humans, the major metabolite of MNA is 2PY, and in rodents, the major metabolite of MNA is 4PY) [6567]
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Figure 3 Patient A also had a likely pathogenic variant in SLC22A5 (p.Ala214Val) indicative of primary carnitine deficiency but needed additional data to prove that conclusively (Invitae, San Francisco, USA)
Rich sources of carnitine are meat and dairy products, while some carnitine may be needed from the diet, since the body does not have a sufficient amount
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