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It's approved for short-term use (a few weeks) only

The most sophisticated L-carnitine study found normal levels of total carnitine but reduced levels of individual carnitines, which correlated well with increased fatigue levels

doi: 10.1038/s41392-023-01486-5 53 YangDHanZOppenheimJJ

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However, based on the structure and triprotic nature of NAD + it was anticipated that the protonation of these moieties will influence the already pH-dependent redox potential of the system