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doi: 10.1016/j.redox.2019.101412

They likely reflect the difference between pathological IGF-1 excess (which does appear to increase cancer risk and accelerate ageing in some models) and normalisation of IGF-1 in individuals whose levels have declined below an optimal physiological range due to somatopause

Secondary carnitine deficiency: Develops as a consequence of another condition, such as chronic kidney disease, liver disease, or certain intestinal disorders that impair carnitine absorption