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To demonstrate carnitines role in lipid metabolism, there are some rare genetic diseases in which the subject is unable to produce endogenous carnitine

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The Journal of physiology, 532(Pt 2), 283

What to expect with Carnitine Deficiency In developed countries, most cases of PCD (Primary Ciliary Dyskinesia) are detected through newborn screening tests

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When the energy demand is high, inhibition of the isoform ACC2 of acetyl-CoA carboxylase increases fatty acid oxidation, while inhibition of the isoform ACC1 decreases fatty acid synthesis