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Peer review Peer review information Nature thanks the anonymous reviewers for their contribution to the peer review of this work

Fermentation uses microorganisms capable of converting precursors such as trimethyllysine into L-carnitine through an enzymatic cascade, such as Escherichia coli

The dietary intake of Carnitine is highly variable

The best quality evidence is that which demonstrates significant positive outcomes, on human subjects, in multiple, double-blinded controlled studies

We referenced medical literature and insights from our internal clinical data at Allo Health, based on treating over 2.5 lakh men with erectile dysfunction across India