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Its clinical relevance in humans emerged in 2011, when researchers at the Cleveland Clinic revealed that gut microbial metabolism of choline produces TMAO, and that elevated plasma TMAO predicts cardiovascular events like heart attack and stroke[1]

59 While most cases of canthaxanthin-induced retinopathy are asymptomatic, this patient had significant visual loss that gradually improved after discontinuing the supplement, highlighting that high-dose canthaxanthin can cause retinal crystal accumulation and visual impairment

When referred to a specialist, the urologist may undertake a duplex Doppler ultrasound combined with an intracavernosal vasoactive agent

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