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 Trimethylamine and Trimethylamine N Oxide, a Flavin Containing Monooxygenase 3 (FMO3) Mediated Host Microbiome Metabolic Axis Implicated in Health and Disease Drug Metabolism and Disposition 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 FMO3 (Metabolism)