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 ( Low Bioavailability and High TMAO Production: Novel Insights Into Acetylcarnitine and Carnitine Metabolism KrimsDavis 2025 Molecular Nutrition & Food Research Wiley Online Library Full article: Gut microbes with the gbu genes determine TMAO production from L carnitine intake and serve as a biomarker for precision nutrition The Role of Microbiome in Cardiovascular Health: Insights for Primary Care Interventions Cureus
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