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Only the L-isomer of carnitine is biologically active

In addition, TMAO induces several inflammatory pathways, which cause the activation of pro-inflammatory cytokines such as IL-6 and TNF- which causes chronic inflammation thereby causing plaque formation and plaque rupture leading to cardiovascular disease [71]

However, some studies suggest that while LC supplementation raises TMAO levels, it does not necessarily correlate with adverse cardiovascular outcomes in all populations

In contrast, beta diversity evaluates the variations in microbial composition of separate communities, reflecting the degree of similarity or dissimilarity between them [30, 31]

doi: 10.1023/A:1007638025856

According to the OSL risk assessment approach, intakes up to 2000 mg/day of LC equivalents for chronic supplementation provide high evidence of safety, and this amount is designated as the observed safe level (OSL)