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By demethylating H3K27, JMJD3 reverses the gene silencing effect, allowing methylated H3K4 to facilitate gene transcription [58, 59]

In addition to the CPT1 isoforms, humans express three other carnitine acyltransferases including carnitine palmitoyltransferase 2 (CPT2 or CPT-II), carnitine O-acetyltransferase (CRAT), and carnitine octanoyltransferase (CROT)

Greater metabolic flexibility is linked to improved insulin sensitivity, steadier glucose control, and better endurance

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In some patients, this temporarily raises uric acid and can trigger a gout flare in the first few months