Trimethylamine N oxide (TMAO) is a small molecule produced in humans primarily by the gut liver axis and has become an important biomarker, and possible mediator, of cardiometabolic and renal disease. Dietary choline, phosphatidylcholine ( Acetyl L carnitine & Your Brain Cognitive Vitality Alzheimer's Drug Discovery Foundation The adverse effects of long term l carnitine supplementation on liver and kidney function in rats L Liu, D M Zhang, M X Wang, C Y Fan, F Zhou, S J Wang, L D Kong, 2015 Can diet modulate trimethylamine N oxide (TMAO) production? What do we know so far? European Journal of Nutrition Springer Nature Link JCI l Carnitine in omnivorous diets induces an atherogenic gut microbial pathway in humans PDF) Atherosclerosis Amelioration by Allicin in Raw Garlic through Gut Microbiota and Trimethylamine N Oxide Modulation