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Patients homozygous for p.N32S had lower mean plasma carnitine levels, the lowest mean residual OCTN2 carnitine transport activity in their fibroblasts, and had a high risk of having symptoms (hypoglycemia or cardiomyopathy in children, sudden death or fatigue in adults) [142], with plasma and tissue carnitine levels dropping rapidly after discontinuation of oral carnitine supplements [143]

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Studies in glioblastoma, melanoma, and breast cancer have demonstrated that methionine restriction can suppress tumor growth, induce cell cycle arrest, and sensitize tumors to chemotherapy and immune checkpoint inhibitors