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Final Thoughts and Recommendations For individuals with high triglycerides, a multi-faceted approach is crucial

Studies have shown that the key enzyme responsible for producing TMA is choline TMA-lyase (CutC), which is a glycyl radical enzyme requiring the activating protein CutD to assist its function

More than 4 million items of tirzepatide and semaglutide were dispensed on the NHS in England in 2025/2026 1 , while around 2.5 million people each month accessed GLP-1s privately at the end of 2025, according to James Kingsland, chair of the Digital Clinical Excellence (DiCE) network of primary care digital health providers

The majority of patients begin with a low dosage and progressively raise it to the one that suits them best