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6 Multiple microbes in both the small and large intestines can convert dietary L-carnitine into GBB, but relatively few can transform GBB into TMA.13 The GBB-to-TMA conversion is much higher in omnivores than in vegans and vegetarians, likely because of differences in the gut microbiota, although this aspect of the L-carnitine-to-TMAO pathway is not fully understood

481 Carnitine deficiency is confirmed by measurements of plasma free and total carnitine with an acyl:free carnitine ratio greater than 0.4 (ie, [total free carnitine] free carnitine) or a total serum carnitine value less than 40 mol/L (Table 28)

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Horses without regular access to pasture, or those in intense training, may benefit from supplemental bioavailable forms to help maintain optimal antioxidant status and recovery capacity