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In the heart, ROS generation arises primarily from mitochondrial dysfunction during ischemia and heart failure, with additional contributions from NADPH oxidase (NOX2/NOX4) and xanthine oxidase pathways, promoting cardiomyocyte injury and fibrosis (60, 61)

Thus, a low-meat diet provides less L-carnitine

Note: not all the countries/places have easy access to compounding pharmacies

FIGURE 6 These observations align with a cross-sectional study in 51 adults with obesity suggesting altered TMAO metabolism in postmenopausal women ( post hoc analysis excluding the three female participants in the Older group, which are of postmenopausal age based on reports by the WHO ( n = 3

Healthy Controls (HC)

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