Trimethylamine N oxide (TMAO) is a small molecule produced in humans primarily by the gut liver axis and has become an important biomarker, and possible mediator, of cardiometabolic and renal disease. Dietary choline, phosphatidylcholine ( TMAO metaorganismal pathway and chronic inflammatory diseases The anti atherogenic bioactive metabolites of natural medicine generated by host microbe co metabolism system. The terminal metabolites of low bioavailable polysaccharides are SCFAs, among which propionate and butyrate can effectively attenuate Full article: Trimethylamine N oxide formation, the bacterial taxa involved and intervention strategies to reduce its concentration in the human body