Betaine is obtained from foods such as wheat, shellfish, spinach, and beets. In the intestine, betaine is metabolized to trimethylamine (TMA) by the gut microbiota (Peptoclostridium acidaminophilum). The toxicity of betaine is due to the formation of TMA and its metabolism to Trimethylamine N-oxide (TMAO) in the liver. TMA is created from betaine via the enzyme betaine reductase in the intestinal microbe, then TMA then enters the bloodstream and is transported to the liver where dimethylaniline monooxygenase [N-oxide-forming] 3 converts TMA to TMAO. TMAO has negative effects on organs such as the heart, kidney and vascular system by contributing to cardiovascular disease, atherosclerosis, endothelial dysfunction and kidney disease.

Betaine Drug Metabolism References