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Consistent with the role of KG in de novo carnitine synthesis through TMLHE, we observed an increase in H2AX foci following TMLHE knockdown, which was rescued by l-carnitine and acetylcarnitine, but was not markedly rescued by KG, propionylcarnitine or butyrylcarnitine (Fig

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Concurrent conditions such as anaemia, thyroid dysfunction, depression, sleep disorders, or inadequate nutritional intake should be investigated, particularly if fatigue is severe or worsening