L Carnitine is Underrated. New Meta Review Reminds Us Why. The Role of l Carnitine in Mitochondria, Prevention of Metabolic Inflexibility and Disease Initiation Short Note On Carnitine Shuttle: Fatty acids are oxidized in mitochondria, and synthesized in the cytoplasm. Long chain fatty acids must form an active intermediate, fatty acyl CoA, before being oxidized inside mitochondria. Catherine Oxidation of Fatty Acids: Ketogenesis Basicmedical Key Nutritional and Hormonal Regulation of Citrate and Carnitine Acylcarnitine Transporters: Two Mitochondrial Carriers Involved in Fatty Acid Metabolism