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While L-carnitine supplementation normalized plasma carnitine concentration in vegetarians to that observed in omnivores, there was no effect on energy metabolism and physical performance compared to no supplementation and between vegetarians and omnivores (131)

In summary, carnitine plays a multifaceted role in cardiac energy metabolism and protection, but its level needs to be finely regulated to avoid potential cardiac damage

Therapeutic strategies target TMAO levels through microbiota modulation

Philadelphia: Lippincott, Williams & Wilkins

Specifically, we used genetic variants to predict l-carnitine, and obtained their associations with coronary artery disease (CAD), ischemic stroke, heart failure, and atrial fibrillation, as well as CVD risk factors (type 2 diabetes, glucose, HbA1c, insulin, lipid profile, blood pressure and body mass index) in large consortia and established cohorts, as well as sex-specific association in the UK Biobank