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Without making this post needlessly long, I will briefly summarize the evidence

It has been fully approved by the UK's medicines regulator (the MHRA)

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TMAO concentrations correlate positively with various pathological conditions, including cardiovascular disease, diabetes, cancer, autoimmune disorders, bone metabolic diseases, polycystic ovary syndrome, and autism, while showing a negative correlation with conditions such as dementia and IBD (171)