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Koeth et al stated they fed their mice a 1.3% carnitine diet, (Steak is 0.01% carnitine), and Ling Ding et al stated they fed mice 2.6g/kg compared to a human supplemental dose of carnitine, around 0.007g/kg, of which maybe only a fraction would be converted in TMAO

If the condition does not respond to NSAIDs, a doctor may suggest: conventional disease-modifying antirheumatic drugs (DMARDs) tumor necrosis factor inhibitors corticosteroid injections other biologic medications or JAK inhibitors A doctor may recommend surgery in cases where there is severe damage

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Many semaglutide formulations now include B12 , and tirzepatide with B12 is similarly available

The recommended dosage is 300-400mg, taken one hour before going to bed