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Non-specific symptoms and signs are loss of appetite, diarrhoea, fatigue and weakness, shortness of breath, low blood pressure, confusion, and change in mental states.9 29 Classical manifestations include Hunters glossitis, megaloblastic anaemia, and subacute combined degeneration of spinal cord (Table 29)

Authors' conclusions Due to the limited number of included trials, shortterm treatment, and inadequate reporting, we were unable to draw any conclusions about the efficacy or safety of Lcarnitine for cognitive enhancement in healthy adults

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