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 Carnitine: the claims and why it may not work Can Acetyl L Carnitine Help Clear Brain Fog and Fatigue in Long COVID and ME CFS? RTHM 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.