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This is often because circulating levels are subject to varying levels of homeostatic regulation, reflecting not only intake but also absorption, distribution across tissues, metabolism to other compounds, and excretion, he says. Johanna Lampe, PhD, RD, research professor in the Department of Epidemiology at the University of Washington School of Public Health and associate director of the Public Health Services Division at Fred Hutchinson Cancer Research Center in Seattle, says about 95% of TMA is converted to TMAO in the liver