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An animal study conducted by Koeth and colleagues found that TMAO decreases the bile acid pool size and inhibits the expressions of the key BA synthetic enzymes (Cyp7a1 and Cyp27a1) and BA transporters (Oatp1, Oatp4, Mrp2, and Ntcp) in the liver (Koeth et al., 2013)

In addition, when the circulating L-carnitine concentration increases, as in the case of oral supplementation, the renal reabsorption of L-carnitine may become saturated, resulting in the increased urinary excretion of L-carnitine

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However, creatine can increase water retention inside muscle tissue, so brands should explain that scale weight may rise even when body composition is improving

The cause of death was neonatal CPT II deficiency

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