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J Gerontol A Biol Sci Med Sci 64: 927939, 2009

In cultured pulmonary endothelial cells in vitro, carnitine can effectively reduce the apoptosis, damage to migration and obstruction of angiogenesis caused by hyperoxia, resulting in improvements in endothelial cell dysfunction and persistent lung injury under hyperoxic conditions [308]

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The elevated TMAO levels, along with the patients medical history of liver cirrhosis and recent dietary and lifestyle changes, were consistent with secondary TMAU, most likely exacerbated by the use of L-carnitine supplements, which are rich in the precursor for TMA production