An individual developed a condition characterized by progressive muscle weakness and aching muscle cramps. The symptoms were aggravated by fasting, exercise, and a high-fat diet. After several experiments, the patient was diagnosed as having a carnitine deficiency. The symptoms were aggravate by a high fat diet, exercise, or fasting because carnitine plays a role in acyl-CoA transport in fatty acid oxidation. Without carnitine, acyl-CoA will build up when trying to process lipids. Out of the pathways in the muscle cell, lipolysis will be the least affected by a carnitine deficiency since it does not occur in the muscle cell. On the other hand, acyl-CoA formation will slow down since there will be a build up of it. Also, beta-oxidation will not be able to coccursince acyl-CoA is less transported into the mitochondria.
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