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"The evidence supports the hypothesis that the correlation between L-carnitine and atherosclerosis might be more complex than already postulated and the alteration of mitochondrial DNA (mtDNA) methylation in platelets could be involved in the pathogenesis of this multi-factorial disease," researchers noted

Discontinuation or switching to alternative medications should be considered in cases of prolonged fasting, strict low-carbohydrate diets, excessive alcohol consumption, acute infections, or perioperative periods as they may increase risk [822,823]

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