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 Vaginal epithelial dysfunction is mediated by the microbiome, metabolome, and mTOR signaling: Cell Reports L Carnitine in Autism Spectrum Disorder Encyclopedia MDPI L Carnitine Benefits: A Complete Research Based Guide Development and Application of a UPLCMRMMS Method for Quantifying Trimethylamine, Trimethylamine N Oxide, and Related Metabolites in Individuals with and Without Metabolic Syndrome Pharmacokinetics of L Carnitine : Clinical Pharmacokinetics