Occasionally Dr Dolphin writes posts on the tmau.org.uk forum for TMAU people. Indeed he has been given his own thread there : Questions for Dr Dolphin
Recently he posted an in-depth post about potential therapies for TMAU and the obstacles.
Dr Dolphin's tmau.org.uk post about potential TMAU therapies : link
My non-expert interpretation of the post :
The post suggests 3 potential TMAU therapies and their obstacles :
1. Using bacteria that can oxidize TMA in the gut to TMA-oxide
Obstacle : these bacteria tend to be aerobic (need oxygen) and do not tend to survive well in oxygen-deprived areas (such as the gut)
2. Genetically modifying gut-friendly bacteria with enzymes that oxidize TMA to TMA-oxide
This would seem more possible, but the TMA-oxide may be quickly 'reduced' back to TMA by other gut bacteria enzymes. So it would be a cycle of TMA-TMAO-back to TMA.
3. A drug that blocks the production of TMA from choline/carnitine etc.
Again seems possible but may involve taking many drugs and not really practical ?
Dr Dolphin mentions a final idea where the aim would be to eliminate TMA-producing bacteria in the gut (?). He also mentions how he applied for a grant to check the gut flora of TMAU population against normal people but the application was unsuccessful.
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