l carnitine transports fatty acids to mitochondria in Mitochondrial Acid Transport and β-Oxidation Translating the basic knowledge of

Less ATP promotes more oxidative stress, meaning cells won't have the energy they need to function optimally

The reducing effect of L-carnitine on both TC and TG was found following long-term carnitine supplementation (24 weeks), supplementation with doses less than or equal to 2,000 mg/d, and in patients with chronic hepatitis C

That is, KDs have shown to be beneficial during a long duration ( 12 h), low-intensity ultra-endurance-type event, where mitochondrial beta-oxidation can match lower rates of ATP demand, whereas the combination of nutritional ketosis and high carbohydrate intake may confer performance benefits in endurance events of moderate intensity and durations of 8 h (54)

Chiechio S, Canonico PL, Grilli M