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This rapidly and significantly lowers VPA levels

-Butyrobetaine (-BB) -BB, formed by the oxidation of TMABA, is the immediate precursor to L-carnitine

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[DOI] [PMC free article] [PubMed] [Google Scholar] 39.van den Pol A.N., Gao X.B., Obrietan K., Kilduff T.S., Belousov A.B

2017 meta-analysis: A meta-analysis of 17 clinical trials including 1,625 adults with chronic heart failure found that 16 g/day L-carnitine supplements for 7 days to 3 years improved left ventricular ejection fraction by 4.14%, stroke volume by 8.21 mL, and cardiac output by 0.88 L/min compared to routine treatment