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A landmark study published in Nature Medicine (Koeth et al., 2013) demonstrated that gut bacteria metabolise L-carnitine into trimethylamine N-oxide (TMAO), a compound associated with atherosclerosis in animal and observational human studies

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Interestingly, a number of studies have shown that dl-carnitine has a similar effect in many fish species to l-carnitine to reduce whole-body lipid content, when used at the same dose ( Reference Du, Liu and Tian 24 , Reference Tian, Leng and Li 29 )

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