TMAO: how gut microbiota contributes to heart failure Translational Research L carnitine supplements can cause a fishy odor in the breath, sweat, and urine. This is likely due to the formation of trimethylamine (TMA). TMA is also responsible for the pungent smell of Trimethylaminuria, or fish odour syndrome is an uncommon condition that causes an unpleasant, fishy smell. The body is unable to turn a strong smelling chemical called trimethylamine produced in the gut when Role of L carnitine in Cardiovascular Health: Literature Review Cureus Comprehensive review of the expanding roles of the carnitine pool in metabolic physiology: beyond fatty acid oxidation Journal of Translational Medicine Springer Nature Link