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In their study of patients who are not on the diet, carnitine deficiency was found in 32 out of their 84 (38%) patients taking valproic acid and 13 out of 54 (24%) taking carbamazepine, both as monotherapy and utilized in combination with other ASMs

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This is why supplementation becomes more relevant as the decades pass

The MTHFR gene variant is carried by approximately 40% of the population and impairs conversion of folic acid to active methylfolate