1. FRIMICUTES is the most critical phylum associated with ischemic stroke. 2. TMAO enhances atherosclerosis which leads to strokes and other cardiovascular diseases. 3. Higher TMAO levels were associated with ischemic strokes on admission before a significant decrease at 48 hrs. 4. Elevated Firmicutes/Bacteroides ratio is the hallmark of aging. 5. Butyrate is a metabolite produced by Odoribacter that enhances the anti-inflammatory effect by lessening the Lipopolysaccharide-induced NF-KB activation, resulting in decreased ischemic injury by increasing IRF3 activity. The gene discussed is NFKB1; the disease is atherosclerosis.