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It has been estimated that approximately one-third of AAS users may develop a dependence syndrome, characterized by withdrawal symptoms and continued use despite awareness of negative health or social consequences (62)

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This most commonly occurs in various forms of veganism, where animal-based products, the primary source of carnitine, are excluded

Because skeletal and cardiac muscles have the greatest quantities, they are unable to synthesis carnitine and must obtain it from plasma

Repeated application is often required for optimal results