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5,6365 It is important for laboratories to flag those patients with very low HDL-c to requesting clinicians as they may require further investigation, after exclusion of secondary causes, for inborn errors of metabolism such as hypoalphalipoproteinaemia, as may be caused by Tangier, Fish Eye disease or Apo AI gene mutations such as ApoA1 Milano and very high levels seen in hyperalphalipoproteinaemia

However, using liquid carnitine may be a safer option to promote weight loss as it works indirectly on fat

Demidchik 2015

Cognitive impairment of patients with HE mainly affects areas that require multiple and complicated functions, such as attention, visuospatial abilities, psychomotor speed, balance, and coordination, rather than language or general intellect