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Recently, Pescosolido and colleagues [161] evaluated the presence of carnitine in tears of dry eye patients and suggested that the damage incurred on the ocular surface of dry eye patients may, in part, be due to a lack of carnitine in the tear film of these patients relative to the ocular surface cells and suggested use of solutions containing carnitine to reduce this damage

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Its levels are mainly driven by food: diets rich in red meat and egg yolks increase TMAO via microbial metabolism of carnitine and choline, while fish contains pre-formed TMAO that spikes blood levels after meals