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Other clinically relevant conditions may determine secondary carnitine deficiency, that is, intestinal resection, severe infections, liver disease, and cancer [88] where a negative impact on skeletal muscle is demonstrated by the appearance of pathological manifestations, including fibers accumulation of neutral lipids, structural damages, and subsarcolemmal accumulation of large aggregates of mitochondria

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However, always consult a doctor if you are combining it with prescription medications