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Indirect Support The main difference between the two is how they enter your system

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Your liver makes it, but stress, alcohol, pollution and aging burn through it faster than you replace it

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Genetic Influences and Complex Pathways The gut microbiotas first step in converting unabsorbed carnitine into TMA is generation of the intermediate gamma-butyrobetaine (GBB), which has been shown to be atherogenic in mice, although research in humans is inconclusive