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Written by Elena Brull, FNR, Functional Nutrition Researcher & Womens Health Journalist About the Author Elena Brull, FNR, is a Functional Nutrition Researcher and Womens Health Journalist specializing in integrative approaches to hormonal balance, nutrition, and longevity

Using more than one strategy is often helpful

Putting it together: realistic guidance If you suspect deficiency because of fatigue, unintentional weight loss, or anemia, get tested and follow evidence-based replacement if indicated

Renal carnitine loss may also affect the morphology and function of red blood cells and reduce the oxygen carrying and releasing capacity of red blood cells, thereby reducing tissue oxygen supply (including the kidney), and tissue hypoxia activates hypoxia-inducible factor 1 (HIF-1), which in turn reduces OCTN2 expression through the HIF-1-PPAR signaling pathway