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Secondary carnitine deficiency can be caused by increased losses, pharmacological therapy, a number of inherited metabolic disorders [38], poor diet or malabsorption of carnitine, from increased renal tubular loss of free carnitine (Fanconi syndrome), haemodialysis, peritoneal dialysis, or the increased excretion of acylcarnitines[39] with certain drugs

It is also indicated to prevent and treat carnitine deficiency in end-stage renal disease patients undergoing dialysis

Elevated IGF-1 levels have been linked to enhanced chondrocyte proliferation, cartilage matrix production, and osteoblast differentiationmechanisms that support fracture healing and joint preservation

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It is likely that these might fully indicate BPC 157 therapy as a particular activity [20]