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Secondary carnitine deficiency or depletion Secondary carnitine deficiency or depletion may result from either genetic or acquired conditions

The mitochondria are often referred to as the powerhouses of the cell because they generate most of the cells supply of adenosine triphosphate (ATP), used as a source of energy

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That's because most zinc is stored inside cells, and levels of zinc in the plasma or serum are influenced by factors unrelated to depletion, such as recent meals, time of day, muscle breakdown during weight loss, and inflammation

Although several factors, such as insulin resistance, abnormal protein metabolism, and uremic toxins, have been involved in the loss of skeletal muscle mass in HD patients [12, 13], several reports suggest that muscle atrophy is attributed to carnitine deficiency in HD patients [14, 15]