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Water is enough for most, though electrolyte drinks help in warmer conditions

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During exercise, the muscle signals its energy requirements to the liver by changing the concentration of acylcarnitine in the blood, and the liver adjusts its metabolic activity to increase the synthesis and release of energy substances [223, 224], support muscle contraction and meet the energy demands of exercise [225, 226]

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In patients with a lower serum carnitine level and need for higher-dose ESA, erythrocyte membranes develop osmotic fragility