Trimethylaminuria (TMAU; main trimethylaminuria), also referred to as fish odor syndrome or fish malodor syndrome, is an uncommon metabolic disease which is responsible for a defect in the standard creation of an enzyme termed flavin-containing monooxygenase 3 (FMO3). If FMO3 isn’t functioning properly or when insufficient enzyme is created, the body loses the capacity to correctly convert trimethylamine (TMA) from precursor chemicals in food digestion in to trimethylamine oxide (TMAO), via a procedure called N-oxidation. Trimethylamine subsequently builds up and can be discharged in the individual’s perspiration, urine, and breath, giving off a powerful fishy odor or robust body odor. A version of TMAU (secondary trimethylaminuria or even TMAU2) is where there isn’t any genetic origin, yet excess TMA is secreted, maybe because of intestinal dysbiosis, altered metabolic, or hormonal causes.
Symptoms of Trimethylaminuria
Trimethylamine accumulates in the bodies of individuals with trimethylaminuria. The trimethylamine is discharged in the individual’s sweat, urine, reproductive fluids, and breath, giving off a powerful fishy or body odor. Some individuals with trimethylaminuria possess a powerful odor all the time, but many possess a moderate odor that changes in strength with time. People with this condition don’t have any physical symptoms, and they generally appear healthy.
The condition seems to be more common in women than men, for unknown reasons. Researchers suspect that such female sex hormones like progesterone and estrogen aggravate the problem. According to many reports, the illness worsens throughout puberty. In women, symptoms can worsen just before and during menstrual cycle, after taking oral contraceptives, also about menopause.
The odor appears to change based on many known elements, such as diet, hormonal fluctuations, stress level, quantity of perspiration, other scents in the area, and the viewer’s sense of smell.
Treatment of Trimethylaminuria
The clinical and metabolic indications of TMAU are usually considered benign, since there’s not any related organ dysfunction. This designation, and also the simple fact that the problem can be unrecognised by physicians, can have significant effects such as delayed or missed diagnosis.
Affected people experience shame and humiliation, don’t maintain connections, avoid contact with those who comment on their own condition, and so are obsessive about concealing the odour with hygiene goods and even smoking. The malodorous facet can have severe and damaging impacts on education, private lifestyle, career and associations, leading to social isolation, non self-esteem, depression, paranoid behaviour, and even suicide. Delayed identification, body odour and also the dearth of treatment can lead to psychosocial difficulties. After the problem is suspected or known to happen in a household, genetic testing can be beneficial in identifying the particular people who have or take the disease.
Ways of reducing the fishy odor may include:
- Avoiding foods such as egg yolks, legumes, red meats, fish, beans and other foods that contain choline, carnitine, nitrogen, sulfur and lecithin
- Taking low doses of antibiotics such as neomycin and metronidazole in order to reduce the amount of bacteria in the gut
- Using slightly acidic detergent with a pH between 5.5 and 6.5
Additionally, at least one study has suggested that daily intake of the supplements activated charcoal and copper chlorophyllin may improve the quality of life of individuals afflicted with TMAU by helping their bodies to oxidize and convert TMA to the odorless N-oxide (TMAO) metabolite. Study participants experienced subjective reduction in odor as well as objective reduction in TMA and increase in TMAO concentration measured in their urine. The study found that:
- 85% of test participants experienced complete loss of detectable “fishy” odor
- 10% experienced some reduction in detectable odor
- 5% did not experience any detectable odor reduction
