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Gut microbes can use carnitine and acylcarnitine as carbon sources, nitrogen sources, osmotic protectants or electron acceptors, but the gut microbiota cannot synthesize carnitine itself, and the mitochondrial function of acylcarnitine produced by carnitine palmitoyltransferase has not been observed in prokaryotes [230]

Large meals tend to worsen side effects

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Adjustments to dosage or lifestyle may be required based on results

Also, not every meal is healthy

The post describes baseline pancreatic imaging plus lipase and amylase as standard precautions when a provider decides therapy is appropriate