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There are 2 main types of carnitine deficiency: Primary Carnitine Deficiency: A defective gene gives rise to primary deficiency, where the carnitine is unable to enter the cells from the bloodstream

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Grabner, G

Neuroinflammation in ME/CFS was initially suggested by studies showing elevated levels of pro-inflammatory cytokines, and decreased anti-inflammatory cytokines, in cerebrospinal fluid from lumbar punctures in ME/CFS patients [62, 63], and further supported by a positron emission tomography (PET) study [64], which showed increased binding of a radioligand to 18 kDa translocator protein (TSPO) receptor, the expression of which increases when microglia are activated

The workgroup considered data from 28 of these studies to be most relevant for formulating the guidelines