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In the United States, ME/CFS carries an annual economic burden of approximately $18 billion to $51 billion [13]

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The males, antioxidants, and infertility (MOXI) trial, however, found no benefit in semen parameters, DNA integrity, or live birth rates [22]

Therefore, the regulatory effects of L-carnitine on miRNA expression suggest that it may act as a molecular modulator, exerting both antioxidant and anti-inflammatory effects

While in PCD the amount of carnitine is insufficient (which impairs energy production from fatty acids), CPT1 and CPT2 deficiency affects the binding of fatty acids to carnitine and their use by the mitochondria as an energy source, as described above

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