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Once contributing factors are managed, the first-line interventions for CRF per oncology guidelines are non-pharmacologic: namely exercise , psychosocial interventions , and education [64]

While pure L-carnitine primarily targets the energy demands of the heart and skeletal muscles, other forms, such as Acetyl-L-carnitine (ALCAR), are specifically structured to cross the blood-brain barrier, providing targeted support for neurological function and cognitive stamina

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Pasqualini L, Ministrini S, Lombardini R, Bagaglia F, Paltriccia R, Pippi R, Collebrusco L, Reginato E, Sbroma Tomaro E, Marini E, et al