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By synthesizing existing evidence on potential associations between metabolites and neuropathology, this integrated analysis seeks to offer a preliminary framework that may help prioritize candidate therapeutic targets, provide clues for personalized intervention strategies, and inform future research aimed at improving neurological outcomes in MMAemia

Br J Pharmacol 1992

The relation between TMAO and chronic disease can be ambiguous, involving kidney function [79], disturbed gut-blood barrier [83], or flavin-containing monooxygenase 3 genotype [84]

It binds to these excess acetyl groups to form acetyl-carnitine, which safely removes them from the mitochondria and frees up unesterified Coenzyme A (CoA), a molecule absolutely vital for continued glucose and protein metabolism

These bacteria convert the unabsorbed L-carnitine into TMA, a volatile gas that has a distinct fishy smell [8] [9]