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Given that isotope tracer studies show BB is clearly formed following oral l-carnitine ingestion, and similarly, isotope-labeled BB was readily converted into isotope-labeled TMA/TMAO following oral ingestion, we hypothesized that low overall plasma concentrations of gut microbiotaproduced BB in humans may be the result of microbial BB breakdown into TMA, predominantly occurring in the lower intestinal track (colon) distal to the absorption of most nutrients like l-carnitine and BB

doi:10.1111/j.1753-4887.2011.00387.x Mingorance C, Duluc L, Chalopin M, et al

4.2 Impact of TMAO on DCs DCs, as the most potent professional antigen-presenting cells in the body, play a pivotal role in antigen recognition and signal transmission during immune response

Since the body cannot make it on its own, we rely on food sources or supplements to obtain it