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Science 334 , 986990 (2011)

"Given the significant risk of bias present in the majority of the included trials, further well-designed and comprehensive RCTs with larger sample sizes and robust analytical methods are needed to more accurately determine the influence of L-carnitine on cardiovascular disease (CVD) risk factors in individuals with diabetes and glucose intolerance," the researchers concluded

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Furthermore, side effects which are more specific to serotonin or NE also have become a concern [104106]