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However, these effects are not present in the group supplemented only by the same dose of l-carnitine without any additional supplements [54]

[PubMed] [CrossRef] Walter JH

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They represent what rigorous clinical development looks like: Phase I through Phase III trials, post-marketing surveillance, and manufacturer accountability

How long you feel the effects can depend on your starting levels, which is why people with a larger deficiency sometimes notice the benefits over a longer stretch