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Acknowledgements The authors acknowledge the support of NIH grants DK126715 (R.D.C.), F32HD095620 (P.S.), K99DK127065 (P.S.), R00 DK127065 (P.S.), Brain and Behaviour Research Foundation Young Investigator Award (P.S.), Foundation for Prader Willi Research (P.S.), Courage Therapeutics (R.D.C.) and The Klarman Family Foundation (R.D.C.)

Interestingly, a study conducted by Meng et al 14 showed that TMAO could further activate CSNS and initiate arrhythmia via direct way through the left stellate ganglion and indirect mechanisms by the central nervous system

As a food supplement rather than a licensed medicine, berberine products are not subject to the same quality controls as prescription medications, meaning contamination, mislabelling, or inconsistent dosing may occur