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Intracellular glutathione levels decline with age, chronic inflammation, and certain genetic variations affecting glutathione synthesis or recycling

Notably, TMAOs cardiac effects follow concentration gradients: moderate concentrations (10100 M) reduce LVDP and dP/dt by inhibiting coronary hemodynamics, while high concentrations (300 M) worsen systolic inhibition and elevate LVEDP (Naghipour et al., 2023), indicating deteriorating pump function

Requires daily injection but produces significant body composition changes over 3 to 6 months

BMC Pediatr 17(1):159 Luzzatto L, Seneca E (2014) G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications