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Hypothalamic carnitine palmitoyltransferase is involved, along with fatty acid synthase in the regulation of the melanocortin system, and since many factors including TNF- and IL-1 inhibit fatty acid oxidation [88, 89], it is conceivable that l-carnitine supplementation may affect energy intake in cachectic patients

This triple pathway activity is the reason Retatrutide has produced such significant results during clinical trials