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Scheen AJ (2019) SGLT2 inhibitor or GLP-1 receptor agonist in type 2 diabetes

L-carnitine is another precursor of TMA that is typically obtained from meat (red meat is exceptionally high in L-carnitine) and eggs

Small blood vessels under the skin may leak slightly, creating temporary discoloration

NICE and British Society for Haematology guidelines recommend: Initial treatment with hydroxocobalamin (the preferred form in the UK) via intramuscular injection For patients without neurological involvement: 1 mg IM three times a week for 2 weeks For patients with neurological involvement: 1 mg IM on alternate days until no further improvement Maintenance: 1 mg every 3 months for patients without neurological involvement