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Genetic Influences and Complex Pathways The gut microbiotas first step in converting unabsorbed carnitine into TMA is generation of the intermediate gamma-butyrobetaine (GBB), which has been shown to be atherogenic in mice, although research in humans is inconclusive

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This affects nerve polarization and modulates neurotransmitter levels, thereby changing nerve excitability

doi: 10.1186/s12944-016-0277-5

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