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There are also other potential inhibitors, It was reported that many choline-utilizing gut microorganisms can hydrolyze phosphatidylcholine (PC) using a phospholipase D (PLD) enzyme and further convert the released choline to TMA ( Statements Author contributions YZ: Conceptualization, Writingoriginal draft

Inborn errors Congenital defects involve enzyme deficiencies in the carnitine transport or metabolic pathways, such as CPT II deficiency, which affects the function of the carnitine transporter CPT II and leads to impaired fatty acid -oxidation, and CACT deficiency, which affects the function of the carnitine transporter CACT and results in carnitine shuttle dysfunction

Zuniga KE, Bishop NJ, Turner AS

Timing: Preferably before a meal