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Widely distributed in foods from animal, but not plant sources, L-carnitine is also synthesized by the liver and kidney from two essential amino acids, lysine and methionine

However, high choline and betaine levels are associated with higher risk of future major cardiac events only with concomitant increased levels of TMAO [33]

Compounded medications not FDA-approved and does not undergo FDA review for safety, effectiveness, or manufacturing

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10.1002/hup.611 [DOI] [PubMed] [Google Scholar] McGeehan AJ, Olive MF, 2003