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In addition to the aforementioned remodelling of the metabolome in fatigue-associated diseases, including long COVID, acylcarnitines have emerged as important modulators of CNS function [29]: In both mice and humans, different classes of acylcarnitines have been found to be altered in either mouse models of depression or humans with MDD, with associations to symptom severity and also treatment response, as reviewed by Liu et al

They concluded that these improvements were related to the acetyl L-carnitine (ALC)/ALA combinations ability to protect and repair age-induced mitochondrial DNA damage, thereby boosting mitochondrial function and improving energy turnover

10.1016/j.neuropharm.2004.10.002 Neuropharmacology 31 BaoA

However, factors like aging, poor diet, and lack of sleep can lead to a decline in natural production