N-Acetyl Cysteine (NAC) NAC is a precursor to glutathione
Once inside the mitochondrial matrix, a second enzyme, Carnitine Palmitoyltransferase 2 (CPT2), detaches the L-Carnitine, releasing the fatty acid so it can undergo beta-oxidationa process that breaks down the fat into acetyl-CoA

Dietary modifications form the cornerstone of management: Reduce sulfur-rich foods : Temporarily limit consumption of red meat, eggs, dairy products, cruciferous vegetables, garlic, onions, and protein supplements Avoid trigger foods : Identify and minimise foods that personally exacerbate symptoms, such as processed foods, carbonated beverages, and artificial sweeteners Increase fibre gradually : A balanced fibre intake supports healthy gut motility, but introduce it slowly to avoid worsening bloating Stay well-hydrated : Adequate water intake (approximately 68 glasses daily) supports digestion and helps prevent constipation Eating habits and lifestyle adjustments can significantly impact symptom severity: Eat smaller, more frequent meals rather than large portions Chew food thoroughly and eat slowly to reduce air swallowing Avoid lying down immediately after eating

During periods of fasting, improper utilization of fatty acids impairs gluconeogenesis and characteristically leads to nonketotic or hypoketotic (no or minimal ketone body production respectively) hypoglycemia.[3] When fatty acid oxidation is impaired, glucose is readily consumed without replenishment from gluconeogenesis.[6] In carnitine deficiency states, various intermediary metabolic pathways such as Kreb's cycle, amino acid metabolism, and beta-oxidation of fatty acids are also affected
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