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Supplement Facts: Serving Size: 1 bottle (80ml) Servings Per Container: 12 Amount Per Serving: L-Carnitine: 4000mg Green Tea Extract: 10mg Zinc: 1.5mg (15% RI) Selenium: 8.2g (15% RI) Energy kcal: 12kcal Energy kJ: 50kJ Protein: 0g Carbohydrate: 0g of which sugars: 0g Fat: 0g of which saturates: 0g Fibre: 0g Salt: 0g *RI - Reference Intake Ingredients: water, l-carnitine, acidity regulators: citric acid, malic acid, trisodium citrate, camellia sinensis green tea extract powder, flavouring, colouring agent: safflower extract, preserving agents: sodium benzoate, potassium sorbate, sweeteners: acesulfame potassium, sucralose, colouring agent: brilliant blue fcf, zinc gluconate, sodium selenate

### **Medical necessity** The patients diagnosis must be documented in the record to establish medical necessity