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L-carnitine, produced in small amounts by the body and found in dietary sources such as red meat, fish, and dairy, is also widely available in the form of supplements, used to enhance physical performance, promote weight loss, and support cognitive health

Undigested carbohydrates, in particular, can feed bacteria that produce inflammatory compounds rather than the beneficial metabolites that support GLP-1 production

On top of that, quercetin fights inflammation through the NF-B signaling pathway, which controls inflammatory gene expression

[28] Healthcare providers should assess treatment response through hormonal levels, physical symptoms, or sperm analysis

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thus the total score ranged from 0-40 points, with higher scores indicating greater fatigue and/or greater effects of fatigue on quality of life