After menopause, women’s bodies produce more of a substance called TMAO that can increase heart disease risk. Researchers tested whether a supplement made from pomegranate, red clover, and other plants could lower TMAO levels in postmenopausal women. The study found that the plant-based supplement did reduce TMAO, but the effect worked best in women whose bodies could process certain compounds in a specific way. This suggests that personalized medicine—tailoring treatments based on how individual bodies work—might be a better approach to protecting heart health after menopause.

The Quick Take

  • What they studied: Whether a supplement made from plant compounds (polyphenols) could lower TMAO, a substance linked to heart disease risk that increases after menopause
  • Who participated: 210 healthy women total: 120 younger women still having periods (used for comparison) and 90 postmenopausal women (who took the supplement or placebo). All postmenopausal women were not taking medications to allow clear results.
  • Key finding: The plant supplement reduced urinary TMAO and related compounds compared to placebo, but the effect was strongest in women whose bodies could process the plant compounds in certain ways (about 39% of participants showed the best results)
  • What it means for you: Plant-based supplements may help reduce heart disease risk markers after menopause, but effectiveness appears to depend on individual body chemistry. This suggests future treatments might need to be personalized based on how your body processes certain compounds. More research is needed before making changes to your routine.

The Research Details

This was a randomized controlled trial, which is considered one of the most reliable types of studies. Researchers compared two groups of postmenopausal women: one group received a supplement containing plant compounds from pomegranate, red clover, and Polygonum cuspidatum, while the other group received a placebo (fake pill). The study used a crossover design, meaning each woman received both the real supplement and the placebo at different times, allowing researchers to see how each woman responded to both treatments.

The researchers measured TMAO and related compounds in both urine and blood samples using advanced laboratory techniques. They also grouped women based on their body’s ability to process certain plant compounds (called metabotyping), which allowed them to see if the supplement worked better for some women than others.

To get clear results, the researchers only included women who weren’t taking medications. While this made the study harder to conduct, it meant they could be sure any changes came from the supplement and not from drug interactions.

Understanding how menopause changes heart disease risk is important because women’s heart disease risk increases significantly after menopause. The study’s approach of looking at individual differences in how bodies process plant compounds represents a shift toward ‘precision medicine’—treatments tailored to how your specific body works rather than one-size-fits-all approaches.

This study has several strengths: it used a randomized controlled design (the gold standard), included a placebo group for comparison, used advanced laboratory testing methods, and examined individual differences in response. However, the sample size was moderate (210 women), and all participants were healthy and not taking medications, which may not represent all postmenopausal women. The study was published in a peer-reviewed journal, meaning other experts reviewed the work before publication.

What the Results Show

The plant supplement reduced TMAO levels in urine compared to placebo, which is the main finding. However, the effect was not uniform across all women—it worked best in women whose bodies could produce certain metabolites (urolithin A and equol). About 39% of women showed the strongest response, particularly those in two specific metabolite groups.

Interestingly, the supplement did not change TMAO levels in the blood, only in urine. This suggests the supplement may affect how the body processes and eliminates TMAO rather than preventing its formation entirely. The supplement also reduced DMA (dimethylamine), a related compound, but only in women who could produce urolithin A.

The researchers found that postmenopausal women had higher baseline TMAO levels than younger women still having periods, confirming that menopause does increase this heart-risk marker. The good news is that the supplement appeared to reverse this increase in the women who responded best to it.

The study found that the supplement’s effectiveness was not related to body weight (BMI), age when menopause started, or how many years had passed since menopause. This suggests that the supplement’s benefits depend more on individual body chemistry than on these other factors. The researchers also identified specific combinations of metabolite types that predicted better response to the supplement, supporting the idea that personalized medicine based on body chemistry could improve treatment effectiveness.

Previous research suggested that plant compounds (polyphenols) could reduce TMAO, but results were inconsistent across different studies and people. This study helps explain why—it shows that individual differences in how bodies process these compounds matter significantly. By identifying which women respond best to the supplement, this research moves the field toward more predictable and personalized approaches.

The study only included healthy postmenopausal women not taking medications, so results may not apply to women with existing heart disease or those taking common medications. The sample size was moderate, and all participants were volunteers, which could introduce bias. The study measured TMAO in urine rather than blood, which may not fully reflect what’s happening in the body. Additionally, the study was relatively short-term, so we don’t know if benefits would continue over months or years. More research is needed to confirm these findings and test the supplement in more diverse groups of women.

The Bottom Line

Based on this research, plant-based supplements containing polyphenols may help reduce heart disease risk markers in postmenopausal women, but benefits appear to depend on individual body chemistry. If you’re postmenopausal and concerned about heart health, discuss with your doctor whether this type of supplement might be appropriate for you. However, this single study is not yet strong enough to recommend it as a standard treatment. The confidence level is moderate—the research is promising but needs confirmation in larger, longer studies.

This research is most relevant to postmenopausal women concerned about heart disease risk, particularly those interested in plant-based approaches to health. It may be especially interesting to women who prefer natural supplements over medications. However, women with existing heart disease, those taking multiple medications, or those with specific health conditions should consult their doctors before starting any new supplement. This research is less relevant to younger women or men, though the general principles about personalized medicine apply broadly.

If the supplement does work for you, changes in TMAO levels might occur within weeks based on this study’s timeframe. However, improvements in actual heart health outcomes would take much longer to measure—likely months to years. Don’t expect to feel immediate differences; this supplement would work on invisible markers of heart disease risk rather than producing noticeable symptoms.

Want to Apply This Research?

  • Track daily supplement intake (yes/no) and note any digestive changes or side effects. If you have access to blood work, record TMAO levels from lab tests every 3-6 months to monitor changes over time.
  • If considering this supplement based on your doctor’s recommendation, use the app to set a daily reminder to take it consistently. Log which specific polyphenol sources you’re consuming (pomegranate, red clover, etc.) to track adherence and correlate with any health markers you’re monitoring.
  • Create a long-term tracking system that records supplement use, any changes in energy or digestion, and scheduled lab work results. Set quarterly check-ins to review whether you’re seeing improvements in relevant heart health markers with your healthcare provider.

This research is preliminary and should not be used to replace medical advice from your healthcare provider. The study was conducted in healthy, non-medicated postmenopausal women and may not apply to all women or those with existing health conditions or taking medications. Before starting any new supplement, including those containing polyphenols, consult with your doctor to discuss potential benefits, risks, and interactions with any medications or conditions you may have. This article is for educational purposes only and does not constitute medical advice.