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EMD Serono discontinued the product and its FDA approval was withdrawn due to difficulties in the manufacturing and marketing processes unrelated to its safety or effectiveness [4, 6]

doi: 10.1016/j.ccell.2018.01.011 146 JiaHChenXZhangLChenM

transferred the L-carnitine-dependent microbiota of Wistar rats and found that this inhibits the process of intestinal flora-dependent TMAO-induced atherosclerosis (39)

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Would require sourcing from a reputable compounding pharmacy with appropriate testing