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Acknowledgements This work was supported by the NIA (R00AG037574 and R56AG052981), the Prevent Cancer Foundation, the American Institute for Cancer Research (AICR), the American Federation for Aging Research (AFAR) and Einstein Startup Funds to D.M.H
A recent study found that NRF1 can also regulate GPX4 [12]
This is why the symptoms of primary carnitine deficiency cluster in these organs: the heart weakens (cardiomyopathy), muscles fatigue, and the liver cannot sustain glucose production during fasting, leading to hypoketotic hypoglycemia (low blood sugar without the expected ketone elevation, since ketones also require fat oxidation)
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