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The meta-analysis conclusively found that serum acylcarnitine levels were significantly lower in patients with ME/CFS compared to healthy controls

Effect of acetyl-L-carnitine on the dopaminergic system in aging brain J Neurosci Res 1991

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Imbalanced activation of dopamine and glutamate pathways may be caused by downregulated adenosine signaling that appears to be directly triggered by brain iron deficiency (Mogavero 2026)