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l carnitine deficiency symptoms Blood test and diagnosis and treatment of carnitine Carnitine palmitoyltransferase II deficiency with
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High dose oral cobalamin would be a reasonable alternative as maintenance in patients unable to tolerate intramuscular injections provided there is good compliance with treatment

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J., Evans, P

Other minor detoxification pathways are aldehyde dehydrogenase (ALDH) which catalyzes the oxidation of MGO forming pyruvate, and aldo-keto reductase (AKR) which metabolizes MGO into hydroxy-acetone [22]

Nat Protoc 2(5):10841104

Waas WF, Lo HH, Dalby KN