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However, the production of BB from L -carnitine by a gut microbial process has been suggested (Rebouche and Chenard, 1991

These radicals disrupt bacterial cell membranes and degrade extracellular polysaccharide matrices, killing the bacteria

Although brain cells have low levels of -oxidation, carnitine is actively transported across the bloodbrain barrier and accumulates in neural cells [1]

(In my studies on the history of obesity and diabetes research, I noticed physicians making this assumption a century ago.) They have faith in the pharmaceutical industry to have done its job, and they feel they have more control over the outcome