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DOI: 10.3389/fphar.2019.01297 Fischberg GM et al (2000): Stroke precipitated by moderate blood pressure reduction

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Acetyl-CoA is also an allosteric activator of pyruvate carboxylase that catalyzes the gluconeogenesis pathway which is active during catabolic states such as fasting.[6][15][16] In carnitine deficient states, LCFAs cannot be effectively transported to the mitochondria matrix for oxidation and subsequent utilization in Krebs cycle and ketone body production

1-12, Mansour, Meghan R., et al