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TMAO is the compound responsible for the odor at high doses, and its also at the center of debates about heart health.61 62 Choline and TMAO Elevated blood TMAO has been linked to higher cardiovascular risk in observational studies, but the story is complicated.40Fish is one of the richest sources of TMAO, yet it consistently protects against heart disease.63 Individual microbiomes, kidney function, and the type of choline all affect how much TMAO you make.6 27 64 65 66 67 Free choline salts (like bitartrate, citrate, or chloride) tend to raise TMAO the most

The following antibodies were used: OXPHOS cocktail (1:250 dilution, cat

Value-Based Formularies: Some employers work with PBMs to negotiate formulary placement based on clinical outcomes and rebate transparency

Mol Metab 46:101139

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