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L-carnitine acts as a recipient of an acetyl group in a reaction that releases CoA for use in the Krebs cycle that generates energy (ATP) in the mitochondria

doi: 10.1016/j.vetimm.2013.01.007, PMID: [DOI] [PubMed] [Google Scholar] 174.NRC

Interestingly, the combination of propionyl-L-carnitine and acetyl-L-carnitine appears to be less effective than either supplement alone

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Those results are encouraging for the treatment of HE due to their implications in NH3 metabolism.47 Kidney The kidneys also play an essential role in ammonia homeostasis