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15: Villani, R.G., Gannon, J., Self, M

Measurement of TMA, d 9 -TMA, TMAO, d 9 -TMAO, BB, d 9 -BB, carnitine, d 9 -carnitine, and choline levels in human and culture medium by LC-MS For sample preparation, 1 L of plasma, urine, or culture medium was mixed with 199 L of isotopically labeled internal standards (d 3 -carnitine, d 9 -TMAO, and 13 C 3 -TMAO) in 0.1% formic acid acetonitrile solution

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Post-Exertional Malaise (PEM): By shifting the body away from inefficient anaerobic glycolysis, carnitine helps prevent the rapid, toxic buildup of lactic acid that triggers severe symptom crashes after minimal exertion