Breakthrough in studying the enzyme that ultimately produces fish odour syndrome Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection L carnitine supplements can cause a fishy odor in the breath, sweat, and urine. This is likely due to the formation of trimethylamine (TMA). TMA is also responsible for the pungent smell of Did You Know? Some people report a fishy smell after supplementing with L carnitine. This happens because certain gut bacteria convert carnitine to trimethylamine, a malodorous compound found in rotting fish. Amazon.com: Nutricost Acetyl L Carnitine (ALCAR) 500mg, 180 Capsules, 180 Servings Non GMO and Gluten Free, 1 Capsule per Serving : Everything Else