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If you develop a rash, blisters, or flu-like symptoms, seek emergency medical attention immediately

Lancet 382:339352 Thomas MC, Cooper ME, Zimmet P (2016) Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease

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This multi-step process involves -N-methyltransferasemediated methylation of lysine to form trimethyllysine (TML), followed by sequential oxidation, hydroxylation, and cleavage to generate -butyrobetaine, which is finally hydroxylated by -butyrobetaine hydroxylase (BBOX) to yield free carnitine

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