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Extensive anaerobic subculturing of human feces identified no single commensal capable of l-carnitineTMA transformation, multiple community members that converted l-carnitine to BB, and only 1 Clostridiales bacterium, Emergencia timonensis , that converted BB to TMA

Levocarnitine is generally well-tolerated, but its still a metabolic therapynot a casual supplementand we treat it accordingly

Furthermore, the catabolism of D-serine in the urinary tract has been identified as a key signalling mechanism for virulence gene expression 40,41,42

doi: 10.1161/JAHA.116.005465 40 Nagy-SzakalDBarupalDLeeBCheXWilliamsBKahnEet al

AE-S: conceptualization, experimental design and procedures, and manuscript editing

Changing patterns of infant death over the last 100 years: autopsy experience from a specialist children's hospital