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Secondary carnitine deficiency: Develops as a consequence of another condition, such as chronic kidney disease, liver disease, or certain intestinal disorders that impair carnitine absorption

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Considering that very little is known about the local and temporal concentrations of NADPH and TGR and the multiple redox-associated conformational states, it is difficult to assess how accurately the biochemical assay with recombinant TGR models the inhibition of TGR in worms ex vivo or in vivo

Evidence of benefit in humans does not exist