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As the mitochondria become damaged, they leak their contents into the cellular cytoplasm, which the immune system recognizes as a danger signal, further amplifying the inflammatory response in a vicious, self-perpetuating cycle

The induction of innate immunity causes the production of inflammatory cytokines and biomarkers that contribute to the systemic inflammatory response

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They found a statistically significant lipoprotein (a) lowering effect ( p = 0.01) in groups receiving carnitine and coenzyme Q10, as well as a combination of both, compared to placebo and baseline values, over a period of 3 months

Taken together, these heterogeneous findings highlight both biological plausibility and the methodological constraints that shape the current evidence base, motivating the integrative Discussion below