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The mechanism by which TMAO promotes the complex pathological processes of atherosclerosis is gradually being elucidated and includes cholesterol accumulation, activation of pro-inflammatory pathways, endothelial dysfunction, and thrombosis (62) ( Figure 3 )

Hazen, MD, Ph.D., senior author of the study and section head of Preventive Cardiology & Rehabilitation at the Cleveland Clinic

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Studies have shown that supplementation with D-Carnitine may actually induce a carnitine deficiency, negating the weight loss potential of the carnitine molecule