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Further, while low tryptophan dietary intake is rare, CFS and autoimmune hypothyroidism may be associated with an increment in indeloamine-dioxygenase (IDO) expression, which would promote the tryptophan-kynurenine pathway that decreases serotonin synthesis

Interestingly, a placebo-controlled study (6) has shown that substantial elevations (~20%) of muscle carnitine content do occur in humans following prolonged daily supplementation with carnitine tartrate when carbohydrate is ingested at the same time

Ruggenenti P, et al

In addition to neurological symptoms, fatigue is reported by most patients with MS and is associated with a poor quality of life [56]
