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In an open-label, randomized trial of acetyl-L-carnitine and propionyl-L-carnitine (at a dose of 2 grams per day), improvements were seen in 59% of acetyl-L-carnitine-supplemented patients and 63% of those receiving propionyl-L-carnitine.26 In both groups, attention improved, while fatigue worsened two weeks after treatment was halted

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So when EVOKE and EVOKE+ showed no benefit of semaglutide, it was disappointing but not surprising

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