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however, it improved pain scores in patients with DPN in a phase 2 study

96 A combination of 750 mg silymarin, 200 IU vitamin E, and 1,000 mg L-carnitine per day for 18 weeks reduced blood glucose and insulin levels and improved insulin sensitivity scores more than placebo in a small trial with 25 participants

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This was a critical measure because one of the hypothesized effects of L-carnitine is enhanced fat oxidation, which can improve endurance performance