L carnitine is primarily synthesized in the liver from the amino acids lysine and methionine through a series of four enzymatic reactions, with the liver and kidneys converting the precursor butyrobetaine into active Metabolic therapy for cardiovascular diseases with propionyl L carnitine ScienceDirect Red meat and heart disease link: Not all about the fat? Los Angeles Times L Carnitine with Chromium Wycoff Wellness Primary carnitine deficiency cardiomyopathy International Journal of Cardiology