macula melanotica oral melanotic on the upper gingival mucosa on a 40-year-old Escissione Macula Melanotica Laser Erbio
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Not to be deterred, I continued on

Chronic administration of high doses of oral levocarnitine in patients with severely compromised renal function or in ESRD patients on dialysis may result in accumulation of the potentially toxic metabolites, trimethylamine (TMA) and trimethylamine-N-oxide (TMAO), since these metabolites are normally excreted in the urine

Broski et al
