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Acetyl L-carnitine (ALC) treatment in elderly patients with fatigue

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This process is essential in disorders of mitochondrial fatty acids oxidation where the fatty acyl-CoAs accrual in specific tissues such as in the heart and central nervous system can induce toxicity, trigger apoptosis and inflammation, and destabilize mitochondrial membrane [17,18]

PMID 15591001

Keep in mind, the supplements all work together, or synergistically