What is the role of carnitine (L carnitine) in the management of heart failure? L carnitine is primarily synthesized in the liver from the amino acids lysine and methionine through a series of four enzymatic reactions, with the liver and kidneys converting the precursor butyrobetaine into active JCI l Carnitine in omnivorous diets induces an atherogenic gut microbial pathway in humans TMAO: how gut microbiota contributes to heart failure Translational Research Amazon.com: Vital Nutrients Carnitine 500mg L Carnitine Supplement for Heart Health Support Vegan Energy Support Supplement Gluten, Dairy, Soy Free Non GMO 60 Capsules : Health & Household Primary carnitine deficiency cardiomyopathy International Journal of Cardiology