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This increases the concentration of malonyl-CoA, the first intermediate in fatty acid synthesis, leading to the inhibition of carnitine acyltransferase 1, thereby preventing fatty acid entry into the mitochondrial matrix for oxidation

Many patients return to normal routines with limits

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Additionally, currently accessible laboratory testing may not be a reliable way to direct treatment, as in the cases of mitochondrial function, oestrogen stability and gut microbial ecology, for which there are few, if any, well-established clinical assessments relevant to migraine