Research
Micronutrients & recovery
Choline metabolism by gut bacteria into Trimethylamine (TMA) and subsequently Trimethylamine-N-oxide (TMAO) contributes to NAFLD by decreasing VLDL export and promoting insulin resistance.
Be cautious with high-dose choline supplements if you have NAFLD. Your gut bacteria may convert it to TMAO, which is linked to liver steatosis and insulin resistance.
GoodSupportsHIGH confidence
Increased serum levels of TMAO are consistently associated with liver steatosis in both preclinical and clinical studies... TMAO, by reducing the activity of CYP7A1 and CYP27A1 enzymes, decreases the conversion of cholesterol into bile acids.
Why this rating
Consistent association in preclinical and clinical studies.
Source
Gut Microbiota and NAFLD: Pathogenetic Mechanisms, Microbiota Signatures, and Therapeutic Interventions
Tomas Hrncir et al. · Microorganisms · 2021
DOI 10.3390/microorganisms9050957
narrative_reviewCited 170×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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