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Finally, results of the fecal polymicrobial culture studies indicate that the marked increased generation of TMA (and TMAO) from oral l-carnitine in omnivores versus vegans/vegetarians appears to be due to significantly (up to 10-fold) greater gut microbial conversion of BB to TMA in omnivores relative to vegans/vegetarians (i.e., chronic exposure to l-carnitine in an omnivorous diet is associated with an increase in microbial capacity to catalyze the transformation of BB to TMA

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Koizumi A, Nozaki J, Ohura T, Kayo T, Wada Y, Nezu J, Ohashi R, Tamai I, Shoji Y, Takada G, Kibira S, Matsuishi T, Tsuji A: Genetic epidemiology of the carnitine transporter OCTN2 gene in a Japanese population and phenotypic characterization in Japanese pedigrees with primary systemic carnitine deficiency