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Additionally, Gammaproteobacteria, recognized as opportunistic pathogens, increases susceptibility to intestinal infections and exacerbate inflammation-driven metabolic dysfunction, impairing thyroid hormone utilization (Yao et al., 2020)

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The bioavailability of supplemental acetyl-L-carnitine has not been as well studied, though some evidence suggests slightly higher circulating concentrations compared to equivalent L-carnitine doses, with peak plasma levels typically achieved 2–4 hours after oral administration [5][12]