Stabilizing the enzyme in fish odor syndrome Comparison of short term and long term effects of peroral L carnitine intake: clinical implications of elevated TMAO levels in cardiovascular complications Amazon.com: Nutricost Acetyl L Carnitine (ALCAR) 500mg, 180 Capsules, 180 Servings Non GMO and Gluten Free, 1 Capsule per Serving : Everything Else Compounded Carnitine (L) Injection Empower Pharmacy 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 Frontiers Gut Metabolite Trimethylamine N Oxide in Atherosclerosis: From Mechanism to Therapy