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This effect seems to be dose-related, as patients receiving 5 mg daily showed a mean reduction of about 100 cells/mcL, and those receiving 2.5 mg daily did not have a decrease in lymphocyte count

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For researchers concerned about cardiovascular risk, practical strategies to minimize TMAO production include supporting a healthy gut microbiome through prebiotic and probiotic use, monitoring TMAO levels if testing is available, and keeping total levocarnitine exposure within studied safety ranges