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Interestingly, in a group of seven vegans/vegetarians given 500 mg/day of supplemental L-carnitine for two to three months, only three demonstrated increased GBB-to-TMA conversion.6 There could be a genetic explanation

Inhibition of pyruvate dehydrogenase kinase 2 protects against hepatic steatosis through modulation of tricarboxylic acid cycle anaplerosis and ketogenesis