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Any degradation of carnitine into trimethylamine (TMA) occurs through microbial activity in the gut [28]

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Due to defective renal absorption (free) carnitine is excreted in the urine of patients with primary deficiency and can result in tissue carnitine levels dropping to below 10% of normal [14, 22, 2426]

Pause the supplement if new symptoms or lab abnormalities appear