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They think this may be one of the side effects or is caused by changes in the gut because of the medicine

ACETYL L-CARNITINE - Also known as ALCAR, it is an amino acid produced naturally in nearly all cells in the body

Environ Health Perspect 108:511

Early studies showed that it works as a selective GH secretagogue and that it has a short, well-characterized half-life

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However, the same study mentioned above that noted ipamorelin could neutralize the negative effect of glucocorticoids on bone found similar results for skeletal muscle