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In fact, if a pregnant woman with hypothyroidism is left untreated, her fetus is at a higher risk for congenital disabilities relative to the norm

doi:10.1016/j.drugalcdep.2023.109893 49

They advise against use in patients with personal or family history of MTC or MEN2

Endogenous biosynthesis Humans can synthesize L-carnitine from the amino acids lysine and methionine in a multi-step process occurring across several cell compartments (cytosol, lysosomes, and mitochondria) (reviewed in 6)