I have recently posted in the genetics forums regarding carnitine transporter SNPs and I am doing more research into carnitine. A NutrEval I had done a couple of years ago revealed <dl Lactic Acid and ketones in the urine. From what I understand, ketones require carnitine for formation, however this site seems to claim that they use elevated ketones to diagnose carnitine deficiency: http://www.beyondmthfr.com/organic-acid-test-an-essential-tool-for-gut-methylation-problems/ I have also read that carnitine supplementation reduced plasma lactic acid levels, however it seems possible that the body may be using lactic acid for energy if the fatty acid metabolism is impaired, making lactate levels low. My pyruvic acid levels were high-normal. Does anybody have any insight regarding this?