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Trimethylaminuria seems to be Females may experience more severe symptoms: just before menstruation during menstruation after taking oral contraceptives around menopause Stress levels and diet People with trimethylaminuria do not usually have any symptoms other than a fishlike odor, and the disorder does not cause any other physical health issues

It is also reported that l-carnitine can improve glycemia in T2DM patients (33)

Low carbohydrate intake increases the activity of mitochondrial ALA synthase (ALAS1), leading to the excessive production of heme precursors such as ALA and PBG

Study Visits The timeline of the study is shown in Figure 1