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It requires a bit of planning, but it's entirely manageable

Chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in accumulation of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are normally excreted in the urine

Bargh, J

If you notice sudden vision loss or other concerning changes, seek immediate eye care

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and the subjects who consented to participate in these studies