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Several studies have found a positive association between elevated plasma TMAO levels and mortality, particularly deaths due to cardiovascular and renal disease (Kanitsoraphan et al., 2018

According to Maritan et al

The authors reported, This confirms a profoundly altered myeloid profile in LC. The two findings were of a pair: monocytes tended to be immature and lacked the ability to surveil pathogens, while the T-cells appeared to be aged, highly activated, and headed for senescence and exhaustion

For stimulant-plus-green-tea type fat burners, the strongest ingredients with clinical evidence are caffeine and green tea catechins, like EGCG