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The authors are careful to note the studys limitations, and I want to mention them here

The active ingredient is the same molecule

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Levocarnitine can be metabolized to trimethylamine, an amine with a distinctive fish-like odor that is excreted in sweat, breath, and urine

Based on available evidence, there is no clear indication that semaglutide triggers new-onset autoimmune conditions or worsens existing autoimmune disease activity in most patients, though systematic studies are limited