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Nat Rev Immunol 14(3):154165 Liu J, Chen Z (2011) Traditional Chinese medicine in the new century

Upon oral intake, acetyl-l-carnitine supplements are rapidly deacetylated, i.e., converted back to l-carnitine and acetyl-CoA within the intestinal wall before absorption

Once reconstituted, the 4-week window begins regardless of how the powder was previously stored

More concerning are immune reactions, off-target effects on hormone systems, and changes in blood pressure or glucose

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