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The functionality of the tight junction (TJ) barrier can be tested using tracer molecule of a certain size that cannot pass a properly functioning TJ barrier

Finally, a number of inherited mutations in genes involved in carnitine shuttling and fatty acid oxidation pathways do not systematically result in carnitine depletion (such that carnitine supplementation may not help mitigate the symptoms) but lead to abnormal profiles of acylcarnitine esters in blood (35, 40)

It is also important to consider the fact that the bioavailability of L-carnitine and acylcarnitine derivatives administered orally is low (~10-20%) (see Metabolism and Bioavailability)

and certain disease states (see Primary systemic carnitine deficiency) (12)