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However, observational studies are open to residual confounding, such as by socioeconomic position and health status, and cannot distinguish whether l-carnitine is a biomarker or a causal factor, making them difficult to use as a guide to interventions [17]

doi: 10.1055/s-2007-978596

& Dyck, P

These observations indicate that d 9 -l-carnitine production from oral d 9 -BB occurs via a mechanism that is not suppressed by antibiotics, and are consistent with expected results from the endogenous l-carnitine biosynthetic pathway (i.e., host conversion of BB to l-carnitine during carnitine biosynthesis) (3234)

Finally, for recording fatigue levels, the present study adopted BRAF-NRS Question 1 ( Future directions include prospective randomized controlled trials where the present findings are replicated with more detailed questionnaires and other tests for fatigue, depression, sleep, and stress