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Freo et al
It is worth noting that L-Carnitine in supplements can increase blood levels of trimethylamine-N-oxide (TMAO) over time, high levels of which are associated with a risk of atherosclerosis (clogging of the arteries)

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Carnitine deficiency impairs the mitochondrial -oxidation of FAs, leading to acute metabolic decompensation, elevated aminotransferase, and hepatic encephalopathy similar to NAFLD (75)