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It also includes internal support through vitamins and supplements

Indeed, in a model of graft-versus-host disease (GVHD), T-cell-depleted bone marrow transplants fed with TMAO-rich diet exhibited a significant increase in the frequency of F4/80 + CD11b + CD16/32 + inflammatory macrophages relative to the F4/80 + CD11b + whole population, worsening disease severity, and increasing mortality (80)

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Its impact does not depend on testosterone, estrogen, progesterone, or thyroid levels

It always seemed overly simplistic to me that these new treatments were just making people eat less