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A study in a Chinese population found that patients with ALS, a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, had lower levels of TMAO, choline, and -butyrobetaine, but higher levels of carnitine and betaine [96]

This has practical implications for athletes aiming to improve their ability to sustain high-intensity efforts for longer periods (Table 4)

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This popularity, however, has led to a parallel rise in counterfeit and substandard products flooding online marketplaces and even some wholesale channels