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However, some fish studies also reported that dietary l-carnitine could increase the muscle carnitine content in African catfish and zebrafish ( Reference Li, Li and Qin 27 , Reference Ozrio, Uktoseja and Huisman 50 , Reference Ozrio, Van Ginneken and Van den Thillart 51 )

NAC in very high doses (above 1800mg daily) can theoretically affect cysteine metabolism and insulin signalling, which may be relevant for diabetic patients on tirzepatide, but this is uncommon at standard supplementation levels

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