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Furthermore, TMAO induces reactive oxygen species (ROS) generation in macrophages, creating a feed-forward loop that amplifies both inflammatory responses and oxidative stress ( 4.2 Impact of TMAO on DCs DCs, as the most potent professional antigen-presenting cells in the body, play a pivotal role in antigen recognition and signal transmission during immune response

Some research suggests that chronic high-dose L-carnitine supplementation may increase TMAO levels via gut bacteria metabolism, and elevated TMAO has been associated with increased cardiovascular risk in observational studies

Rips J, Almashanu S, Mandel H, et al

Those wanting to boost their immune system

Additionally, insulin stimulates hepatocytes to synthesize triglycerides and storage of triglycerides in adipose tissue