Research
Hormonal
Dietary intake of choline and L-carnitine leads to the gut microbial production of Trimethylamine (TMA), which is converted by host liver enzymes (FMO3) into Trimethylamine N-oxide (TMAO).
Eating foods rich in choline (eggs, meat) and carnitine (red meat) provides the raw materials for your gut bacteria to create TMA, which your liver turns into TMAO. This process is the primary way diet influences TMAO levels.
StrongSupportsVERY_HIGH confidence
TMAO is formed from trimethylamine (TMA), which is generated by the action of gut microbiota from dietary choline and phosphatidylcholine (lecithin)... L-carnitine is first converted into the intermediate metabolite γ-butyrobetaine and then into TMA, which is subsequently converted into TMAO by host hepatic flavin monooxygenases 3 (FMO3).
Why this rating
Well-established biochemical pathway supported by multiple studies cited.
Source
Trimethylamine N-Oxide: The Good, the Bad and the Unknown
Manuel Velasquez et al. · Toxins · 2016
DOI 10.3390/toxins8110326
narrative_reviewCited 496×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Elevated plasma levels of Trimethylamine N-oxide (TMAO) are associated with an increased risk of major adverse cardiovascular events, atherosclerosis, and mortality in patients with chronic kidney disease.Good
- Therapeutic strategies to reduce TMAO levels, including broad-spectrum antibiotics, dietary restriction of precursors, and specific inhibitors like 3,3-dimethyl-1-butanol (DMB), can attenuate atherosclerosis and cardiovascular risk.Good
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