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It is also important to consider the fact that the bioavailability of L-carnitine and acylcarnitine derivatives administered orally is low (~10-20%) (see Metabolism and Bioavailability)
it is an ongoing, iterative process that in many cases requires patients to weigh competing treatment paths, make lifestyle tradeoffs, and choose among providers over months and years
Starting a new medication can come with some ups and downs like side effects
Furthermore, adherence to nutritional treatment can be an obstacle
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Just like the stomach, muscle contractions in the intestines move digestive materials along through the system
