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Metabolic Concerns TMAO (Trimethylamine N-Oxide) Production: Recent concern (2025): Approximately 90% of oral ALC metabolized to TMAO by gut microbiota[21] Plasma TMAO levels: Can reach 50 M after supplementation (1.5 g dose)[21] Cardiovascular risk: Elevated TMAO previously associated with adverse cardiovascular outcomes in observational studies Clinical significance: Uncertain

1 In a study in which TMA production from dietary precursors could be observed using an in vitro human intestinal model, the conversion rate of precursors to TMA was determined, from highest to lowest, as choline, carnitine, betaine, and -butyrobetaine, respectively

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Human disorders of ubiquitination and proteasomal degradation

Had to take more than the recommended dosage

22 This study was conducted to scientifically validate the weight loss properties of a standardized green coffee bean extract containing seven isomers of CGAs