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Its who we are and its in our blood

Evidence has shown that L-carnitine can promote mitochondrial biogenesis by upregulating peroxisome proliferator-activated receptor-gamma coactivator-1alpha (PGC-1), a master regulator of mitochondrial biogenesis [14] and that L-carnitine promotes mitochondrial protein acetylation, a chemical modification that improves mitochondrial function and protects against stressors

L-carnitine in humans is both endogenously synthesized and obtained through food ingestion and is also used as a drug

There is no explanation for this wide phenotypic variation based on the current understanding of CDSP, though other genetic and/or environmental modifier factors may play a role