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We next studied which of the isolated human commensals were necessary and sufficient to metabolize l-carnitine to TMA

Monitor for any paradoxical reactions

This slow dose escalation helps the body adjust to the medication and reduces the risk of side effects such as nausea

For ongoing prevention, patients should aim for gradual fibre intake (2530g daily), adequate hydration (at least 1.52 litres of fluid daily, unless advised to restrict fluids due to heart or kidney conditions), and smaller, more frequent meals to manage both conditions effectively