News & Views on Systemic Body Odor and Halitosis such as trimethylaminuria TMAU. If you have fecal odors or bowel odors it may be metabolic/systemic

27 February 2016

UK TMAO Study : Not Hazen

Another TMA-oxide study to do with Heart Failure.
It was a big study, tested many.
The authors not associated to Cleveland Clinic
Conclusion seems to be TMAO is related to HF outcome.

As trimethylamine is the only documented volatile to cause metabolic malodor, any research to do with TMA metabolism in humans is of interest to this blog. Regular readers will be aware of a TMA-oxide - Heart Disease theory first put forward by Hazen et al at Cleveland in 2011

Study : Suzuki et al : Leicester UK Feb 2016
Trimethylamine N-oxide and prognosis in acute heart failure

This new study is of interest because :
It does not involve the Hazen group or the Cleveland Clinic. It is a Hospital research unit in Leicester UK.
It was quite a big study (972 samples).
It seems to suggest there may be a connection between TMAO and Heart Failure, thus sort of endorsing the Hazen et al theory.
It's the biggest study I have seen to endorse this theory, outside of the Hazen et al group

elevated levels were associated with poor prognosis at 1 year and combination of TMAO and NT-proBNP provided additional prognostic information. TMAO was a univariate predictor of death and death/HF, and remained an independent predictor until adjusted for renal confounders.

What is this to do with systemic malodor ?
TMAU is the only metabolic/systemic malodor 'disorder' documented for now. I suspect for most people with metabolic malodor they have guessed the right enzyme (FMO3) but that they can smell of FMO3 substrates, not just TMA. But any research to do with TMA metabolism or FMO3 is helpful. As it is now being associated with Heart Disease, a lot of funding will go in to researching this.

My comment :
I am still open-minded whether there is a connection with TMAO and CVD, chronic kidney disease, diabetes etc. although this is the 2nd paper I have seen suggesting there may be a link. Perhaps it's more to do with TMAO being a signature biomarker of gut dysbiosis in general. But I am glad TMA is suddenly getting all this funding and research. After years of no interest, suddenly $millions is going into research TMA metabolism.

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survey still OPEN

TMA blocker pill (links)

P&G - Cleveland press release aug 2015
1st mention of 'DMB pill' dec 2015
FMO3 DNA testing
Update Aug 17 :
Genos is back with it's EXOME test

Note :
Exome/Genome testing may be better option than single gene testing.

See this post : link

Note : Genos Exome Testing.

Exome testing is almost the same price now as single gene testing. Also Genos is consumer friendly, which standard DNA labs are not.

So the blog offer to test solely for FMO3 is almost obsolete, and so no longer offered.

Does Genos fully sequence FMO3 gene ?

At the moment it is not clear, but hoped this will become clear over the next few months

Note : possible 'wild west' way of testing FMO3
Use an ancestry dna site and rummage through the raw data

TMAU Webinar #5 : Preti et al