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Description
-Butyrobetaine (GBB), a metabolite of dietary L-carnitine, is involved in the transformation of L-carnitine to the pro-atherogenic metabolite TMAO (Zeisel and Da Costa, 2009

In a study on almost 300 people, fish and meat consumption increased blood TMAO levels [38]

Pharmaceutical Drugs & L-Carnitine Deficiency Prescription medications, properly prescribed, are a leading cause of death in the United States

In large human studies, elevated TMAO levels have been independently associated with atherosclerotic heart disease and have been shown to predict major adverse cardiac events [68]

Hormonal Influences Hormones such as insulin and glucagon modulate carnitine biosynthesis by altering the activity of key enzymes

doi: 10.1073/pnas.95.26.15592
