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This can make it difficult to identify this symptom as a sign of cauda equina syndrome

Arentz S, Abbott JA, Smith CA, Bensoussan A

Neuroscience 23(3):981989 Kim C-H, Leung A, Huh YH, Yang E, Kim D-J, Leblanc P, Ryu H, Kim K, Kim D-W, Garland EM (2011) Norepinephrine deficiency is caused by combined abnormal mRNA processing and defective protein trafficking of dopamine -hydroxylase

doi: 10.1016/S0196-9781(99)00036-4 154 LeviteM

Holland, W

Also, Escherichia coli , Citrobacter , Klebsiella pneaumoniae , and Shigella , Achromobacter from the strain of Betaproteobacteria , Sporosarcina from Firmicutes , and Actinobacteria have enzymes that can lead to the conversion of all food compounds including choline, betaine, lecithin, gamma-butyrobetaine, ergothioneine and L-carnitine into TMA