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Samples for TMAO levels quantification were prepared as follows: an amount of 25 L of each sample was collected, and 3 L of D9-TMAO (5 M concentration) and 122 L of a cold acetonitrile:methanol mixture (50:50, v/v) were added for protein precipitation

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Free L-carnitine is excreted in urine

Exp Appl Med Sci

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The observed pattern of medication use does not align with our specialty clinics initial approach to ME/CFS, which typically focuses first on fatigue, brain fog, and postexertional malaise, but is as expected based on the average knowledge of ME/CFS treatment in the general medical field