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Most people who eat meat get enough dietary carnitine

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When unabsorbed L-carnitine reaches the large intestine (often due to taking too large of a single dose), certain gut bacteria can metabolize it into a compound called trimethylamine (TMA)

Biochem Biophys Acta 1546:2143 Rebouche CJ (2004) Kinetics, pharmacokinetics, and regulation of l-carnitine and acetyl-l-carnitine metabolism

Pregnancy induces transcriptional activation of the peripheral innate immune system and increases oxidative DNA damage among healthy third trimester pregnant women