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Mixed states in bipolar disorder: etiology, pathogenesis and treatment

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Carnitine, Acylcarnitines and Fatty Acid Transport into Mitochondria The substrates for oxidation and most of the energy production in cells are unesterified fatty acids, which originate from three main sources: exogenous fatty acids that enter cells from the circulation, either from the diet or by mobilization from other tissues, those that arise via synthesis de novo from acetyl-CoA, and those released within the cell by the hydrolysis of phospholipids and triacylglycerols

This structural failure results in the hallmark blood pooling and compensatory tachycardia of POTS