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Studies suggest that approximately 60% of hepatic fat derives from adipose tissue lipolysis, 25% from DNL, and 15% from dietary sources [7]

K.PutluriV.et al (2011)

However, contrary to studies in the general populations, no evidence for TMAO-induced platelet hyperreactivity was detected in HIV-infected individuals (Ma et al., 2017), and endothelial cell adhesion by activated leukocytes (Seldin et al., 2016), which were mediated by activation of the NF-B signaling pathway

The common effects GI upset and the fishy odor are dose-related, benign, and reversible, and the controlled trials report good overall tolerability without serious adverse events as a feature