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Acknowledgements The authors acknowledge the efforts of Prof Omnia ElRashidy one of the founders of the Pediatric Ketoclinic and Prof Ehab Khairy Emam the Head of the Pediatric Gastroenterology, Hepatology and Clinical Nutrition Unit, at the children`s Hospital, Faculty of Medicine, Ain shams University, for their support

The FDA's 2023 updated guidance on bulk drug substances under Section 503A does not include interaction testing as a requirement for compounded peptides (FDA Compounding Quality Center) [12]

You wake up in the morning feeling really tired, your mouth is dry, or you feel very sleepy throughout the day, impacting your daily functioning and mental health

AC system activation generates an increase of the intracellular secondary messenger, cyclic adenosine monophosphate (cAMP), through the conversion of adenosine triphosphate, which then results in the activation of protein kinase A (PKA) and exchange protein activated by cAMP (Epac) [32,33,34,35]

Eine berdosierung von L-Carnitin ist selten, da berschssiges L-Carnitin vom Krper ausgeschieden wird, aber es ist ratsam, die empfohlene Dosierung einzuhalten