Carnitine_tekst Molecule of the Month September 2003 PDF) The Role of l Carnitine in Mitochondria, Prevention of Metabolic Inflexibility and Disease Initiation 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 Carnitine homeostasis, mitochondrial function and cardiovascular disease ScienceDirect