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The numbers from major trials are compelling

Patients with diabetic retinopathy, diabetic neuropathy, and both diabetes and hyperlipidemia had a significantly lower total and free carnitine level compared with the diabetic patients without complications or co-morbidities

Clin Pharmacokinet 50(2):8198

Factors such as baseline gut motility, dietary habits, concurrent medications, and metabolic health may all influence how prominently these symptoms present

Additionally, efficacy concerns might lead to batch recalls, regulatory issues or expensive reimbursement claims

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