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In addition, chronic dietary exposure to l-carnitine results in induction of enhanced gut microbiota catabolism of l-carnitine principally mediated by the second step BB catabolism producing TMA resulting in greater TMAO generation in the omnivorous versus the vegan/vegetarian host (Figure 10)

Oral l-carnitine supplementation normalizes the plasma carnitine stores and slightly increases the skeletal muscle carnitine content in vegetarians, but without affecting muscle function and energy metabolism

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Biomolecules 10(2):320