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The exact cause of chronic fatigue syndrome remains unknown, but experts believe it is triggered by a combination of psychological and physical factors

7th edition

Lets look at how TMAO is made: In the gut, bacteria can turn choline, betaine, L-carnitine, ergothioneine (from mushrooms), and other choline-containing compounds into trimethylamine N-oxide (TMA)

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Fertilit masculine Balercia G, et al