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The journey to your personal therapeutic dose happens gradually through a titration schedule that usually spans 16 to 20 weeks
The carboxylate group of carnitine forms a salt bridge with the guanidinium group of R471 (TM11), as well as a hydrogen bonding interaction with the hydroxyl of Y447 (TM10), both residues from the C-terminal bundle
Therapy continues as long as positive changes occur and is adjusted or discontinued if plateaus develop or goals are achieved
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