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The mitochondrial membranes are impermeable to coenzyme A(CoA) esters and long-chain fatty acids, binding of L-carnitine to acetyl groups via carnitine acyltransferase is essential for the shuttle of the acetylated fatty acids into the mitochondria and their subsequent oxidation

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Watch for possible symptoms, such as a lump or swelling in the neck, trouble swallowing, hoarseness, or shortness of breath