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While the liver is the primary site of drug metabolism, it has recently been discovered that almost all oral drugs affect the gut microbiome (Vich Vila et al., 2020)

Lanzino M, Garofalo C, Morelli C, Le Pera M, Casaburi I, McPhaul MJ, et al

And since this pathway is essential in the promotion of cellular growth, proliferation and longevity

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doi: 10.1016/j.immuni.2016.09.008 Summary Keywords trimethylamine N-oxide, coronary artery disease, diabetes mellitus, major adverse cardiovascular events, prospective cohort study Citation Yu X, Wang Y, Yang R, Wang Z, Wang X, Wang S, Zhang W, Dong J, Chen W, Ji F and Gao W (2024) Trimethylamine N-oxide predicts cardiovascular events in coronary artery disease patients with diabetes mellitus: a prospective cohort study