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Those with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should avoid these medications
However, because this excretion accounts for less than 1% of total acylcarnitine elimination in urine [43], it is unlikely that excretion of VPA alone is sufficient to produce carnitine deficiency in well nourished patients [44]
Neither addresses follicle health at the cellular level
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