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Antioxid Redox Signal 13(2):193247 Saudubray JM, Charpentier C (2018) Inborn errors of metabolism overview

37 years of body mass index and dementia: effect modification by the APOE genotype: observations from the prospective population study of women in Gothenburg, Sweden

A meta-analysis study showed that for L-carnitine to have significant effects on FBG levels in patients with diabetes, 2 grams/day should be taken as a supplement for at least 36 weeks, also it is estimated that 2 g of L-carnitine per day is needed for at least 106 weeks to have a significant effect on HbA1c levels (87)

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It is worth noting that temporal dynamics reveal bidirectional regulation: early (24 h) TMAO inhibits TNF signaling to suppress inflammation, while later (48 h) it activates NOD-like receptors and enhances IL-6 expression (Shanmugham et al., 2023), forming an early inhibition-late activation pattern