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Abstract Trimethylamine- N -oxide (TMAO) is a gut microbiome-derived metabolite of choline, L-carnitine and lecithin, abundant in animal source foods

However, L-carnitine supplements are necessary only in a subset of patients taking valproic acid

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[DOI] [PubMed] [Google Scholar] 82.Costa ND, Stevenson PM

Kidney damagethe mechanism of this problem is not completely known, but we do know that "flushing" the kidneys (diuresing with large volumes of fluids) prior to and during the administration of the drug usually prevents kidney damage