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Apart from exocytosis, a portion of the lipid vesicle-containing complex would fuse with the lysosome

Two novel missense mutations of the OCTN2 gene (W283R and V446F) in a patient with primary systemic carnitine deficiency

Their diet should include a lot of carbohydrates and low fat, where they get their energy from medium-chain triglycerides, that can enter the energy-producing parts of cells even without the presence of a carnitine transport system.

PMID: 27126549 3 Trimethylamine and Trimethylamine N-Oxide, a Flavin-Containing Monooxygenase 3 (FMO3)-Mediated Host-Microbiome Metabolic Axis Implicated in Health and Disease

You may have heard of it, possibly tried it, and then like most, dismissed it as another snake oil

TMAO leads to atherosclerosis by changing how cholesterol breaks down, turning on inflammatory pathways, and helping foam cells form [18]