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This phenomenon may be due to saturation of L-carnitine transport into skeletal muscle at physiological L-carnitine plasma concentrations (4060 mol/l) and/or by the significantly higher carnitine concentration in skeletal muscle relative to plasma, rendering passive transport impossible [24]
Any of these warrant immediate medical evaluation and possible dose adjustment or discontinuation of one or both agents
Reducing the dose may help if lightheadedness is persistent
Estrogen therapy has been shown to reduce abdominal fat accumulation, improve insulin sensitivity, and support lean muscle preservation
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