PCD is characterized by low plasma carnitine levels, reduced intracellular carnitine, and increased urinary loss.[5] Carnitine is transported intracellularly via OCTN2, which is expressed predominantly in skeletal and cardiac muscles, and kidneys.[3] Decreased OCTN2 on the plasma membrane results in a reduced intracellular update of carnitine.[5] In kidneys, this results in reduced reabsorption of carnitine, and patients with PCD may lose up to 95% of the filtered carnitine in the urine.[6] The parents of a child with PCD, who are heterozygous carriers, may lose twice or thrice the levels of normal urinary excretion.[6] The plasma concentration of acyl-carnitine esters is also low in PCD.[5] Epidemiology The incidence of Primary carnitine deficiency is different based on ethnicity
As fatigue improves, gradually reintroducing moderate exercise such as walking or swimming can help restore energy levels and support metabolic health
While this is a single case report and not necessarily generalizable, it underscores why thyroid monitoring during GLP-1 therapy is not optional, it is essential
If the scale isn't moving, your licensed provider can adjust your dose or switch your medication based on the progress you report on your refill forms and your check-ins
