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Koeth's 2013 study (PMID 23563705) showed that gut bacteria convert dietary carnitine into trimethylamine, which the liver then oxidizes into TMAO (trimethylamine-N-oxide)

The carnitine shuttle is essential to prevent accumulation of long chain fatty acids and long chain acyl-CoAs which can be deleterious to cells [1, 43, 54]

doi: 10.1007/s00406-023-01734-3

It is considered a compound of nutritional interest because of its role in the energy metabolism , as it facilitates the transport of long-chain fatty acids into the mitochondria, where they can be used to produce energy

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