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Nevertheless, several members of the Work Group felt that a short-term trial of L-carnitine was reasonable in selected patients with these symptoms who are unresponsive to other therapies, in light of its favorable side effect profile, lack of alternative effective therapies, and the findings from some studies of improvement in these symptoms with L-carnitine therapy

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These and other data suggest that the web of interactions between these signaling components is indeed very complex (Figure 1)