Particularly, we found that mean plasma levels of Valine (U:140.9 mol/L, K:127.8 mol/L), Lysine (U:109.9 mol/L, K:95.7 mol/L), Threonine (U:67.5 mol/L, K:57.9 mol/L) and Tryptophan (U:2.9 mol/L, K:2.3 mol/L), fell below the expected ranges for healthy adolescents (UCSF Clinical Core Accepted Reference Ranges) for both those affected with konzo and their unaffected siblings
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This was attributed to the involvement of L-carnitine in mitochondrial transport of fatty acids thus its deficiency affects multiple organs including the smooth muscles in the gastrointestinal tract
Low levels of lithium in the blood or high amounts excreted the urine may require lithium supplementation
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