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Deficiency and deregulation of carnitine metabolism accompanied by slight increases in lactate and serum ammonia in ASD are symptoms of mitochondrial dysfunction [11] (Figure 1)

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From a public-health standpoint, the rising prevalence of AAS use appears to be driven by the normalisation of muscular body ideals, the influence of social media, peer reinforcement within gym environments, and the ease of online access to illicit hormonal agents