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The possible transport mechanisms together with the wide tissue distribution underlie the role of OCTN2 as the major transporter responsible for the traffic of carnitine and carnitine derivatives in the intestine, distribution to several body districts and reabsorption/excretion in the kidney (Figure 2)

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In line with this, a study in rotating shift workers from the automotive industry found that NSW significantly reduced plasma concentrations of multiple immune markers, including pro- and anti-inflammatory cytokines (TNF-, IL-2R, IL-1RA, IL-4, IL-12, IL-17), chemokines (IP-10, MIP-1, MIP-1, RANTES), and growth factors (EGF, FGF, VEGF), indicating a broad suppression of immune pathways linked to circadian disruption and higher susceptibility to infection and cancer 113

While L-Carnitine helps increase the efficiency of using FFAs as an energy source, the end result is more useable energy to support physical endurance

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10.1016/j.bioorg.2019.102925 21 GongF.ChengL.YangN.BetzerO.FengL.ZhouQ.et al (2019)