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The three largest PBMs collectively handle roughly 80% of U.S
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It is in the chemical compound classes of -hydroxyacids and quaternary ammonium compounds, and because of the hydroxyl-substituent, it exists in two stereoisomers, the biologically active enantiomer L-carnitine, and the essentially biologically inactive D-carnitine.[bettersourceneeded] Both are available through chemical synthesis,[not verified in body] and the L-form is continuously biosynthesized in eukaryotic organisms from the proteinogenic amino acids lysine and methionine
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