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Just low levels of some of these substances can make the synthesis of carnitine insufficient

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Martinotti G, Andreoli S, Reina D, Di Nicola M, Ortolani I, Tedeschi D, Fanella F, Pozzi G, Iannoni E, DIddio S (2011) Acetyl-l-carnitine in the treatment of anhedonia, melancholic and negative symptoms in alcohol dependent subjects