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Given that serotonin synthesis pathways are similar between the brain and periphery and across mammalian species, we here examine in humans the following hypotheses in both CFS and hypothyroidism with fatigue: (1) serum serotonin (S-5-HT) levels are low, (2) L-carnitine supplementation is associated with increased S-5-HT levels and reduced fatigue, and (3) there exists a correlation between peripheral S-5-HT and fatigue levels

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