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ALA is therefore not so much a direct benefit to cells, but rather an indirect aid that "kick starts" declining function in cells, helping them recover the functions that came more easily and naturally in the young

The decreased plasma free fatty acid concentrations with carnitine supplementation may be due to more efficient fatty acid oxidation and/or increased urinary excretion of fatty acids as acylcarnitines.

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however, hemodialysis typically reduces valproate concentrations by about 20%