Hamedi-Kalajahi F, Zarezadeh M, Mojtahedi SY, Shabbidar S, Fahimi D, Imani H (2021) Effect of L-carnitine supplementation on lipid profile and apolipoproteins in children on hemodialysis: a randomized placebo-controlled clinical trial
Accepted reasons for clinical necessity include: Intolerance to GI side effects requires a low-dose titration schedule not available commercially Need for split dosing across two or three weekly injections at doses not available commercially Allergy or sensitivity to an inactive ingredient in the commercial formulation, such as benzyl alcohol, excipients, or preservatives Requirement for a preservative-free formulation Therapeutic-additive requirements, such as leucine, methylcobalamin (B12), pyridoxine (B6), or L-carnitine A specific dose strength or concentration not available in any commercial format An alternative delivery method or dosage form not available commercially The clinical necessity must be explicitly documented on the prescription by the ordering prescriber
Additionally, literature has reported that ALA can inhibit RANKL-induced osteoclastogenesis via the FFAR4/arr2 signaling pathway and prevent inflammation, which is consistent with the findings of this study [37]
This discrepancy might be attributable to methodological factors, such as the testing duration
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