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These synthetic forms are not biologically active in the same way as the natural L-isomer and can actually competitively inhibit the absorption and utilization of naturally occurring L-carnitine, potentially inducing a state of carnitine deficiency and worsening fatigue symptoms

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Hyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2

the enzymatic conversion is then an enzymatic hydrolysis