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The treatment approach is a multifaceted, individualized plan prioritizing non-drug strategies such as graded exercise, sleep hygiene, cognitive behavioral therapy, education, mindfulness psychotherapy, and smoking cessation

This suggests that the microbial metabolism of carnitine to TMA and subsequently to TMAO is a significant pathway linking the diet, gut microbiota, and cardiovascular health [61]

We show that this dysbiosis is alleviated by the downregulation of CPT1 by etomoxir or by CPT1A P479L mutation in chronic rotenone-exposed mice, possibly by the shift toward more decreased gut permeability and anti-inflammatory compositions

While triglyceride levels were assessed, additional metabolic or hepatic markers, including pre-treatment FT4 and urinary carnitine/acylcarnitine levels, were not available

During anaerobic glycolysis, lactic acid is produced which promotes acidosis

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