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Grimm M, Han J, Weaver C, et al

26,27 Exposures to endocrine-disrupting chemical toxins such as herbicides and pesticides, compounds from plastics, heavy metals, natural gas and oil, radiofrequency electromagnetic radiation, air pollution, and noise pollution may directly impair testosterone and sperm production in addition to their effects on sperm DNA

Future studies should include newer GLP-1 receptor agonists and combinations, Orandi said

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However, the functional differences between l- and d-carnitine are difficult to study because of the endogenous l-carnitine background