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You may face higher risk if any of these apply: Older age, or existing hearing loss Reduced kidney function Taking several ototoxic medications at once Long treatment courses or high doses Frequent exposure to loud noise If any of these fit, ask about a baseline hearing test before you start

Update on safety profiles of vitamins B1, B6, and B12: a narrative review

If you prefer sleeping on your back, place a pillow under your knees to flatten your lower spine against the mattress

For reference , see this Scientific Context: Study on L-Carnitine & Fat Metabolism