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Next Steps to Feeling Better If you are experiencing symptoms such as fatigue, brain fog, constipation, muscle weakness and aches, and digestive issues even after starting thyroid hormone treatment it can be due to a single root cause, such as a deficiency in carnitine

Moisture ingress or heat exposure above 35C may have started degradation

Cofactor for L-methylmalonyl-coenzyme A mutase 5-Deoxyadenosylcobalamin is required by the enzyme that catalyzes the conversion of L-methylmalonyl-coenzyme A to succinyl-coenzyme A (succinyl-CoA), which then enters the citric acid cycle ( Figure 2 )