Based on the symptoms and muscle biopsy findings you’ve described, the condition may be related to a primary carnitine deficiency or a defect in fatty acid metabolism, potentially pointing to a systemic issue with mitochondrial fatty acid oxidation.
### a) Hormone released during prolonged exercise:
During prolonged exercise, the primary hormone released is **epinephrine** (adrenaline).
**Signal Transduction of Epinephrine:**
1.