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It is esterified to fatty acyl groups by carnitine palmitoyltransferase I (CPT-I), translocated, and converted back by CPT-II inside the mitochondrion

Further increases to 1.7 milligrams and eventually 2.4 milligrams follow at four-week intervals

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This decrease in muscle mass can put more strain on tendons and adjacent bones and potentially lead to a higher risk of injury, though at present this is just hypothetical