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The arginine-to-glutamic acid swap at position 3 changes the surface charge distribution, reducing IGFBP affinity significantly

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L-carnitine acts as a biochemical buffer, binding to these toxic acyl groups and shuttling them out of the mitochondria and into the bloodstream for excretiona process known as "fatty acid dumping." This detoxification process relieves the metabolic pressure on the mitochondria, allowing them to repair and function more efficiently