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l-carnitine can be obtained from dietary sources such as beef, poultry, and dairy products, with the highest content of l-carnitine in red meat (2)

End Stage Renal Disease (ESRD) patients on maintenance hemodialysis may have low plasma carnitine concentrations and an increased ratio of acylcarnitine/carnitine because of reduced intake of meat and dairy products, reduced renal synthesis and dialytic losses

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(3) (4) Finally, those with reduced absorption such as celiac or Crohns disease, weight loss surgery, or intestinal surgery are at an increased risk

The Dangers of Untreated SPCD While the prognosis with treatment is excellent, untreated or chronically poorly managed SPCD is extremely dangerous