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Metabolism of acetaminophen to NAPQI is carried out by various CYP enzymes including CYP1A2, CYP2A6, CYP2D6, CYP2E1, and CYP3A4

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Gut bacteria can metabolize carnitine into trimethylamine, which the liver converts to trimethylamine-N-oxide or TMAO

Other studies were able to increase hepatic carnitine concentrations only when they gave doses higher than 10g/d carnitine available for intestinal absorption, or 20 g/d in abomasal infusion ( Carlson et al ., 2007a