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While gut bacteria metabolize LC into TMA, which is then converted to TMAO in the liver, these derivatives have distinct metabolic pathways and bioavailability, which may influence the amount of TMAO levels [32, 48, 49]

Short term supplementation studies which have been undertaken on athletes and active individuals have shown no consistent responses to exercise performance or metabolism

Interestingly, there was no difference in carnitine levels between MS patients with or without fatigue

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Pharmacological inhibition suggested that activation of mitogen-activated protein kinase (MAPK) and NF-B signaling were required for these processes