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The downregulation of endothelial nitric oxide synthase (eNOS) activity and reduced nitric oxide (NO) bioavailabilitycaused by pro-inflammatory cytokinesare the core preclinical vascular mechanisms of ED in varicocele patients, as NO is the key mediator of penile vasodilation and erection maintenance (204)

While standard L-carnitine is highly effective at supporting skeletal muscle and cardiovascular tissue, it struggles to penetrate the central nervous system

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