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1.2 Biochemical mechanisms of TMA production Most of the TMA is synthesized in the intestine (colon) by the action of some anaerobic commensal gut bacteria containing choline- (or carnitine-) TMA lyase, an enzyme consisting of two units: a catalytic unit (CutC) and its activating enzyme (CutD) ( etc .), betaine, and L-carnitine and its metabolite -butyrobetaine (GBB), releasing TMA after the cleavage of the carbon (C)nitrogen (N) bond of choline/carnitine (Zhu et al., 2014)
18 However, no studies in hu-mans have shown any effect on IOP or visual function
However, subsequent analysis showed that 500mcg produced nearly identical results to 1mg in body composition changes
The shift accounts for the spokes seen clinically (Figs 11 and 12)
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