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When multiple studies conducted by different researchers in different countries all point in the same direction, the conclusion is far more robust than any single trial

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However, subsequent research has shown that carnitine acts to modulate thyroid hormones within our cells, so it can act like an agonist (a substance that initiates a response when combined with a receptor) helping thyroid hormone action in cases of hypothyroidism, and as an antagonist (blocker) in cases of hyperthyroidism