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The liberated L-carnitine immediately goes to work binding to long-chain fatty acids, creating acyl-carnitine, and pulling them into the beta-oxidation cycle to produce ATP

even reviewed clinical observations of behavioral, affective and cognitive features already 20 years ago and hypothesized that atypical depression is a secondary symptom in chronic fatigue syndrome [140]

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however, a lower respiratory quotient was reported, suggesting that performance improvements derived from increased fat oxidation and probable muscle glycogen sparing could be expected [55]