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may lower seizure threshold Chemotherapy: Avoid during active treatment Lifestyle Considerations: Maintain good glycemic control (if diabetic) Regular exercise as tolerated Adequate hydration Balanced diet with adequate protein Special Populations: Elderly: ALC preferred over L-carnitine due to better absorption[2] Renal impairment: Reduce dose if eGFR 1,500 mg/day more effective[8] 2