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Researchers also find that acylcarnitine levels are low and variants in the CPT1B gene add to susceptibility to narcolepsy.[ref] Alzheimers : Clinical trials on L-carnitine or acetyl-L-carnitine supplementation for Alzheimers or mild cognitive impairment have mixed results

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Labs are not perfect, and their failure to strictly comply with these stringent requirements is often the basis for a successful defense to a positive drug test