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Although technically not an amino acid (but a quaternary amine, and a metabolite of two amino acids, lysine and methionine), it not only helps us metabolize fats, proteins, and carbohydrates properly, but also functions as an antioxidant and detoxifying agent

Patients frequently describe this cognitive dysfunction as "brain fog"a terrifying sensation where memories slip away, words become impossible to find, and concentration shatters

However, due to the complexity of strain screening and relatively low fermentation efficiency, much of this research remains at the laboratory stage

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Furthermore, iron serves as cofactor for numerous enzymes, including catalase and peroxidases involved in antioxidant defense, cytochrome P450 enzymes that mediate drug metabolism, and hydroxylases essential for the synthesis of neurotransmitters

The prevalence of HE is reported to be 1014% of cirrhotic patients and 1621% of patients with decompensated liver cirrhosis [206,211]