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The process works like this: intestinal microbiota convert levocarnitine to trimethylamine (TMA), which then travels to the liver where the enzyme FMO3 oxidizes it to TMAO
10.1016/j.phymed.2021.153519 59 ZouS.TongQ.LiuB.HuangW.TianY.FuX
This is the phase where most of the important clinical decisions are made, and why supervision matters
If more than 4 days have passed, skip the missed dose and take your next dose on the regularly scheduled day
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