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4.3 Impact of TMAO on T lymphocytes TMAO can enhance the activation of effector T cells, shown in increased percentages of IFN- + TNF- + CD8 + and CD4 + T cells, and upregulated CD44 expression on CD8 + and CD4 + T cells

There have also been concerns raised in the scientific literature regarding cardiovascular safety

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The levocarnitine component may provide a marginal enhancement, particularly for fat oxidation efficiency and potentially for lean mass preservation, but the evidence for the specific combination is theoretical rather than proven

Carnitine plays a crucial role in energy production by transporting fatty acids to the mitochondria