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Intestinal bacteria produce various bioactive metabolites, which can be absorbed into the enterohepatic circulation and enter the host blood circulation system, affecting host physiology directly or indirectly (7)

Volek, J

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There is insufficient evidence to suggest that nucleoside analogs used in the treatment of HIV infection (i.e., zidovudine [AZT], didanosine [ddI], zalcitabine [ddC], and stavudine [d4T] or certain cancer chemotherapy agents (i.e., ifosfamide, cisplatin) increase the risk of secondary L-carnitine deficiency (135)