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Secondary carnitine deficiency can be caused by increased losses, pharmacological therapy, a number of inherited metabolic disorders [38], poor diet or malabsorption of carnitine, from increased renal tubular loss of free carnitine (Fanconi syndrome), haemodialysis, peritoneal dialysis, or the increased excretion of acylcarnitines[39] with certain drugs

The second step involves adding glycine to -EC to form GSH, catalyzed by glutathione synthetase (GSS) 10

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Nov 2022;13(11):1834-1841