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There is always the possibility that interactions and side effects other than those listed may occur

1) Heart Disease In a meta-analysis of 19 studies with almost 20,000 people, high TMAO levels were associated with increased rates of cardiovascular diseases , such as heart failure and stroke

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A choline analogue, 3,3-dimethylbutanol (DMB), has been uncovered with inhibitory effect to choline TMA lyase activity in turn decreasing circulating TMAO, and therefore attenuating the promoting role of choline in atherosclerosis (Wang et al., 2015)

Palmitylcarnitine inhibition of the calcium pump in cardiac sarcoplasmic reticulum: a possible role in myocardial ischemia

Bioaccumulation of heavy metals in some commercially important fishes from a tropical river estuary suggests higher potential health risk in children than adults