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According to a Cochrane analysis, although some beneficial effects on pain and improvement in vibration perception threshold have been reported, no conclusive evidence has been found to support a significant reduction in pain after 612 months of treatment with acetyl-L-carnitine in patients with DPN [111]

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Adrenal fatigue is a term applied to insufficient functioning of adrenal gland

Publication bias was evaluated visually through funnel plots and formally using Eggers test