Chronic oral administration of high doses of levocarnitine in patients with severely impaired renal function or end-stage renal disease (ESRD) and dialysis patients may lead to accumulation of the potentially toxic metabolites trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), as these metabolites are normally excreted in the urine
GSH transport in mitochondria: defense against TNF-induced oxidative stress and alcohol-induced defect
R., Tabrizi, M., Ghaleiha, A., and Akhondzadeh, S
To help bypass any barriers to absorption in the GI tract, many healthcare providers recommend B12 injections for deficiency, but research shows that very high doses of oral B12 (1,000 to 2,000 mcg once a day) can normalize serum B12 levels to a similar extent with minimal side effects
Following these steps turns a potential problem into a manageable variable