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Three Nutritional Supplements That Can Lower Your Cardiovascular Disease Risk if You Have Elevated TMAO Levels

Analysis by Dr. Joseph Mercola Fact Checked

what causes elevated tmao levels

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  • Krill oil, astaxanthin and berberine may be among the best treatments for those with high trimethylamine-N-oxide (TMAO) levels, which can be a reflection of insulin resistance in the liver
  • You’d also want to normalize your weight. Two strategies that are most helpful in this regard are a cyclical ketogenic diet and intermittent fasting
  • TMAO is a metabolite of dietary choline and carnitine from animal-based foods such as eggs and meat; some research suggests elevated TMAO may be a risk factor for cardiovascular disease
  • There’s virtually no evidence to suggest dietary intake of TMAO or its precursors — fish being one of the richest sources — actually promotes CVD, provided your renal function is normal
  • The likely true cause of elevated TMAO levels is hepatic insulin resistance; poor liver function has been shown to significantly elevate TMAO by increasing FMO3

In recent years, research has suggested trimethylamine-N-oxide (TMAO) might be a therapeutic target for insulin resistance and gastrointestinal (GI) cancers. As noted in one 2017 scientific review:

“Through the digestion of animal protein and other constituents of animal products, the commensal bacteria in the gut (the gut microbiota) forms metabolites that can contribute to the development of both insulin resistance and cancer.


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