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In contrast, levels of blood GSH, tGSH, GSH/GSSG, tGSH/GSSG, SAM/SAH, methionine, cysteine, vitamins (B9, B12, D, and E), and calcium were significantly decreased in ASD children relative to control subjects

doi:10.2337/diabetes.51.2007.S271 65

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In older children or adults it may be considered if there are clinical symptoms suggestive of carnitine deficiency (hypotonia, lethargy), a significant decrease in the serum free carnitine levels, an impairment in hepatic function tests, or hyperammonaemia, even in the absence of VHE