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Systemic metabolic alterations and their relationship to neuropsychiatric symptomatology PAIS, including long COVID, as well as CFS and IMD, share the characteristic of systemic metabolic disturbances, which may be a sign of underlying multi-organ inflammation and exhaustion [31], and consequently may contribute to neuropsychiatric symptomatology, as many metabolites can cross the bloodbrain barrier (BBB) [30, 58] (e.g., short chain fatty acids (SCFAs) derived from the gut microbiota such as acetate [40], amino acids such as tryptophan [52] and also carnitine/acetylcarnitine can cross the BBB via transporters [59])

These early findings are generally described in the literature as modest relative to later-stage results, and researchers note that more pronounced outcomes reported in some sources typically reflect extended, multi-week protocols combined with controlled training and nutritional variables not the compounds effect in isolation

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Also, acetyl-l-carnitine exerts its antioxidant action through the alteration of the expression and oxidative status of a number of proteins involved in mitochondrial function and brain plasticity [23]

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