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This reaction is essentially a reversal of the thiolase (HADHB or ACAA2) catalyzed reaction of fatty acid -oxidation but is in fact catalyzed by the mitochondrial enzyme acetoacetyl-CoA thiolase (encoded by the ACAT1 gene)

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Cayenne Pepper adds a thermogenic boost, slightly raising body heat to help you burn off excess calories naturally

For constipation-related bloating, which is common with these medications, polyethylene glycol (Miralax) or stool softeners may be helpful if not contraindicated for the individual patient