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Using an identical protocol and intravenous L-carnitine & insulin amounts they undertook another study reported in An Acute Increase in Skeletal Muscle Carnitine Content Alters Fuel Metabolism in Resting Human Skeletal Muscle with the broader aim of determining the effect that an increase in skeletal muscle carnitine content would have on the integration of muscle fat and carbohydrate oxidation during and after hyper-insulinemia

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This gray-market status creates a regulatory vacuum where responsibility for quality, purity, and safety falls to the individual user rather than health authorities