Most common searches to do with 'Human Malodor'

An unfortunate issue in raising awareness of metabolic/systemic malodor is that probably most who have a metabolic malodor probably do not realise they have a metabolic problem (thinking it to do with something else such as the skin, bromhidrosis, oral cavity, anus etc).

Probably the main way to connect with the potential community is being found in web searches (mainly google web searches) or via advertising.

Keyword searches for human malodor conditions
Knowing what words people use in searches is a best way to get the idea of how people use searches that may connect them to metabolic malodor, It used to be quite easy to do keyword searches (via the google keyword search tool), but now is much more difficult (the google tool is now for adwords accounts only).

Looking around for an alternative, I did manage to find another limited keyword tool (Uber Suggest).

Keyword popularity for words that may be to do with 'metabolic malodor.'

Number is the rough amount of web searches in Google USA per month 

Halitosis                                110,000

Body Odor                                8,100

   Bad Breath                              33,100   

Trimethylaminuria                    6,600

TMAU                                      3,600

Fish odor syndrome                  2,400

Comments :
From these keyword searches it seems the main malodor word is 'Halitosis'.
'Body Odor' search is surprisingly low.
'Trimethylaminuria' is the most common search to do with that condition ?

Conclusion
It seems we have a long way to go to raise awareness of the concept of systemic/metabolic malodor disorders, even probably among our own.

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By sysbodyodor

common malodor questions, raising awareness

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Fecal Body Odor Reference Table

I will use this post as my 'quick reference table' of my opinion on what cause what seems to be the main complaint on the forums, which is termed as 'Fecal Body Odor'. I will keep updating this post.

Note, others don't agree with me. My own view is that since I do not think the spectrum of systemic body odor is currently defined, any opinion can't be proven/disproven yet. Think of it as understanding the universe.

	my opinion
Fecal Body Odor	caused by the sulfides and amines which are FMO3 'substrates'
FMO3	an enzyme that oxidizes or reduces many sulfides and amines
TMAU ?	means only trimethylamine causes the smell. But I am sceptical those with FMO3 weakness only smell of TMA
How did TMAU diagnosis come about ?	In 1970 some consultants in Denver were told a patient smelt of fish sometimes and tested them only for TMA. Since then no-one has tested for other volatiles

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By sysbodyodor

common malodor questions, fecal body odor, fmo3, FMO3 reference, metabolic malodor, systemic body odor, systemic malodor syndrome

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My theory on Metabolic/Systemic Body Odor/Halitosis

 Almost nothing is known about or being researched about the disorder metabolic/systemic body odor. The following are my theories on the condition

Firstly, I am using metabolic and systemic in this context to mean the same thing.

What is metabolic body odor ?
It is where the person smells of malodorous volatiles that are circulating in the bloodstream. In a normal person these volatiles are probably neutralized by being oxidized. In someone with metabolic body odor, there is probably a mismatch between the amount of volatiles and the ability to neutralize them (probably via oxidizing) causing an overload of the enzyme for some reason.

Metabolic body odor is different from 'surface body odors' or 'local halitosis' in that the smells are not generated on the surface or in the mouth. The smell are from the bloodstream (or perhaps lymph)

Why is trimethylamine the only volatile documented as causing metabolic body odor ?
It's probably the only volatile ever looked for. It was 'discovered' in 1970 in a anecdotal case where the patient's mother said the patient sometimes smelt of fish. The health professionals seem to have guessed this may be trimethylamine and tested for this alone. Since then only about a handful of health professionals or researchers have had any interest in TMAU and probably nothing has been done to check for other volatiles.

Why is FMO3 enzyme a strong suspect for causing the metabolic body odor known on forums as 'fecal body odor' ?
FMO3 enzyme oxidizes many sulfides and amines in humans. Many/most of these are probably smelly. Currently someone with an FMO3 deficiency is only expected to smell of trimethylamine but is also predicted to not handle sulfide and amine compounds well such as drugs. So if people with TMAU say they smell of many bad smells, it seems very possible they are smelling of many FMO3 substrates and not just trimethylamine. Many of these sulfides and amines are probably generated in the colon and then absorbed in the bloodstream.

Any other possible enzymes that could be suspect for 'fecal body odor' ?
Since fecal smells are probably a range of quite a few volatiles, any of the broad-spectrum oxidizing enzymes could possibly be a suspect. The mixed-function oxidase enzymes are a group of enzymes that ozidize a wide range of compounds in hmans. FMO3 is part of this family of enzymes. However my own suspicion is that FMO3 is the main suspect enzyme until proven otherwise.

Other types of metabolic body odor other than 'fecal body odor'
It is very possible that other enzymes could be at fault for various metabolic malodor conditions. However most enzymes tend to 'neutralize' a specific group of volatiles that may tend to give the person one particular smell. For instance carriers of isolvaleric acidemia may have a sweaty sock smell.

But people with 'fecal body odor' seem to have a wide range of malodors probably from a wide range of volatiles, and such a wide range are probably dealt with by one or more of the mixed function oxidizing enzymes  (e.g. FMO3, CYP3A4). So since 'fecal body odor' is probably a wide range of volatiles, it seems more likely to be one of these oxidizing enzymes. 'Fecal body odor ' seems to be the term most use for their malodor complaint.

What needs to be done ?
People with metabolic body odor need :
A phenotype test : An exploratory test that then becomes  a diagnostic test when a pattern emerges. This would probably be an 'untargeted' volatile urine test (which would then become a 'targeted' test when a pattern emerges)
A DNA test : FMO3 would seem to be the main gene test to do, until any other enzymes are made suspects.
A enose consumer sensor : People with any type of body odor/halitosis do not seem to be able to smell their malodor. So it seems that a consumer enose sensor would greatly help anyone with any type of body odor/halitosis. The odors the enose detects would need to be designed to match the type of malodor. For people with 'FMO3 malodor'  it would probably have to detect certain sulfides and amines.        

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By sysbodyodor

common malodor questions, fecal body odor, fmo3, main points, metabolic malodor

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TMAU1 and TMAU2 : Who would smell more ?

Question : Who would smell more between someone with genetic TMAU and someone with secondary TMAU ?

My non-expert reply :
In theory I guess someone with genetic trimethylaminuria is likely to smell more as they in theory should have problems with 'normal' trimethylamine loads, but in practice I am not sure this is always the case.

There are 2 types of TMAU : TMAU1 is genetic deficiency, and TMAU2 is TMA overload. I think quite often people will have a bit of both.

TMAU1
TMAU1 sounds straightforward, but actually it's a % game. That is, how much of a % of TMA can you oxidize to TMA-oxide. FMO3 oxidizes TMA to TMA-oxide, so the % in a urine sample is meant to give you an idea of how well your FMO3 enzyme is working by calculating what % of TMA you oxidized to TMA-oxide.

People may often think someone with a genetic disorder has almost no FMO3 function, but actually a normal person has to oxidize around over 95% of a TMA load to TMAO. Depending on which lab you test at, 'sub-normal' can be anything from under 92% to under 79%. However I believe the subnormal level should be at the upper range of around 92%. So you should oxidize 92% or more of a TMA load to TMAO.

TMAU2
TMAU2 seemingly means any type of TMA overload that is not due to a genetic FMO3 deficiency. In practice it seems to mostly mean people who are generating too much TMA by their gut flora. Very few labs seem to take TMAU2 into account.

Genetic versus Overload (TMAU1 versus TMAU2)
So TMAU1 is due to FMO3 enzyme deficiency of some %, meaning the person has problems with normal TMA loads (in theory), and TMAU2 (mostly) means the person has normal enzyme function but has enormous amounts of TMA that even a normal person cannot fully oxidize.

My view on this :
Personally I don't think most people with an FMO3 isssue have a metabolic malodor problem solely caused by trimethylamine. FMO3 oxidizes many small sulfides and amines, and I am guessing most people who have an issue with their FMO3 enzyme have many circulating unoxidized volatile sulfides and amines that should be oxidized by FMO3 and most are probablty smelly. However TMA is meant to be an excellent biomarker of FMO3 function, though I have my doubts. But anyhow this is my attempt at an explanation of TMAU1 and TMAU2

Most are a mix of TMAU1 and TMAU2
My opinion is that most probably have a few small faults in FMO3 function making them around the 80%-90% efficiency mark, and for some reason are also prone to excess TMA production. A bit of a 'syndrome' (I would call it something like 'FMO3 substrate malodor syndrome'). I don't think very many are the genetically 'severe' type where function may be around 20% etc. There are quite a few common small genetic FMO3 faults that populations carry around, and I'm guessing most of us are a combo of small faults that put us just under the 'normal' function, perhaps even only intermittently. I think they are called something like 'compound heterozygotes' (small faults compounding). 2 common faults are at codons 158 and 308 in the 532 FMO3 amino acid sequence.

TMAO research :
One 'good' thing for the community is that TMAO has recently been hypothesized as being a cause of heart disease (still being debated), and so now a lot of research and funding is likely to go into understanding TMA production in humans and how to neutralise it. For those who feel TMA is the sole volatile that causes their maldoor, this would be very good news.  

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By sysbodyodor

common malodor questions, fecal body odor, metabolic malodor

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