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All L-carnitine benefits are due to its ability to transport fatty acids to the mitochondria, the energy producing structures in cells

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Evidence for beneficial effects in heart failure Subanalyses of the EMPA-REG OUTCOME, CANVAS and DECLARE-TIMI-58 trials suggested consistently that SGLT2 inhibitors may be particularly beneficial in patients with HFrEF [4244]

The honest answer may be that you need pharmaceutical intervention, and there is nothing wrong with that decision