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Dr. Dominic D'Agostino recommends L-carnitine. Are you concerned about issues such as described in this phase 2, prospective, double blinded, randomized, placebo-controlled, two-center trial of people with metabolic syndrome (but not on a ketogenic diet): https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/s12986-022-00661-9
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