Trimethylamine Wikipedia Did You Know? Some people report a fishy smell after supplementing with L carnitine. This happens because certain gut bacteria convert carnitine to trimethylamine, a malodorous compound found in rotting fish. Trimethylamine and Trimethylamine N Oxide, a Flavin Containing Monooxygenase 3 (FMO3) Mediated Host Microbiome Metabolic Axis Implicated in Health and Disease Drug Metabolism and Disposition Understanding the Side Effects of L Carnitine Injection and When to Seek Medical Advice 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