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This is relevant to research protocols that require more controllable dosing windows

Could it be similar to creatine, where strength gains are not so spectacular in sedentary people, so L-carnitine would require an increase in fatty acid oxidation or impaired absorption

However, achieving and maintaining significant weight loss is particularly challenging in patients with T2DM

PMID 16467543

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As an additional benefit, betaine and pepsin can lead to reduced overall inflammation and pain for many people