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For patients experiencing significant symptoms, temporarily pausing therapy, maintaining the current dose for an additional 2-4 weeks before advancing, or implementing smaller dose increments when formulation allows, may improve tolerance

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While B vitamins are water-soluble and are generally excreted in the urine when in excess, extremely large and repeated doses can overwhelm the body's ability to eliminate them efficiently

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L-Carnitine is a natural amino acid derivative important in energy production

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