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Fats cannot be used efficiently as an energy source, which leads to fatigue, decreased performance, triglyceride accumulation and glycogen being depleted more rapidly during exercise

Despite the lack of prospective, randomized clinical trials, a few studies have shown carnitine supplementation in patients receiving VPA to result in subjective and objective improvements and to prevent VHT, in parallel with increases in carnitine serum levels

They may need hospital-based assessment, blood tests, heart evaluation, or specialist care

5 Conclusion In this study, we demonstrate that tyndallized L

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