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In addition, the gut microbiome affects TMA production, and the amount of fiber in the diet can alter the gut microbiome.[ref] In general, older people and people who eat a typical, high-fat Western diet have higher levels of TMAO and are more likely to have atherosclerosis and heart disease

There is a lack of evidence from large, controlled studies to show that some of these supplements consistently work and are completely safe

Yes, B12 shots are considered safe for most individuals

PLoS One 9: e95759, 2014

After initial growth to an OD600 of 0.8, cells were induced using 0.4 mM isopropyl -D-1-thiogalactopyranoside (IPTG) and cultured at 20C for 16 hours