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But most studies that report poor tolerance started subjects at doses two to three times higher than necessary

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However, dietary choline absorption is limited by gut transit time and competes with other nutrients

These changes were associated with enhanced markers of protein translation, indicative of increased protein turnover and amino acid uptake, which provide protection against fibrotic remodeling and diastolic dysfunction [80]

This temporary effect might be another cause for whats causing the situation to get worse before it gets better