Does concurrent supplementation with select B vitamins (B3, B6, B12) change the picture? Or concurrent supplementation with brain penetrant antioxidant cell membrane stabilizers like certain carotenoids (astaxanthin etc.)? When you consume certain fish, carotenoids come bundled in with the various forms of fish oil. Look at choline. Fish come with choline. Supplementing with choline by itself can raise TMAO levels. Fish already have TMAO, and can raise blood levels, at least transiently(*). Yet in general, there doesn’t seem to be evidence of increased atherosclerosis as a result of fish consumption, even though TMAO otherwise can be an exacerbating factor in CVD. Perhaps the supplementation with fishoil alone is suboptimal insofar as its effects are not modified by other molecular constituents found in whole fish. Maybe stick to modest fish consumption?
(*) Circulating trimethylamine N-oxide levels following fish or seafood consumption