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1998;30(Suppl 1):7380

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showed that TMAO not only promoted cellular inflammation but also accounted for oxidative stress, thus playing an indirect role in promoting expression of inflammatory cytokines ( In human umbilical vein endothelial cells (HUVECs) and aortas from ApoE -/- mice, TMAO increased the concentrations of reactive oxygen species (ROS), especially superoxide, by inhibiting the SIRT3-SOD2-mitochondrial ROS signaling pathway ( Endothelial dysfunction and thrombosis TMAO may lead to endothelial dysfunction

"This makes them not worth the risks, proven or unproven." Beyond the possible connection to mania, other research has linked the herbal remedy to health problems that include jaundice, elevated liver enzymes, liver damage requiring a transplant, and one death from liver failure