The Carnitine butyrobetaine trimethylamine N oxide pathway and its association with cardiovascular mortality in patients with carotid atherosclerosis Atherosclerosis 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 ( Emerging role of trimethylamine N oxide (TMAO) in colorectal cancer Applied Microbiology and Biotechnology Springer Nature Link Gut microbe derived metabolite trimethylamine N oxide activates PERK to drive fibrogenic mesenchymal differentiation: iScience Dietary allicin reduces transformation of L carnitine to TMAO through impact on gut microbiota ScienceDirect