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

Showing posts with label metabolic/systemic malodor. Show all posts
Showing posts with label metabolic/systemic malodor. Show all posts

23 June 2018

someday : 'fecal body odor' debate in Parliament ?

Someday politicians could be having a debate about 'fecal body odor' 'metabolic body odor' 'systemic body odor' 'TMAU' in their parliament / senate / congress etc.

Recently a 'M.E.' debate was held in the UK Parliament.

Here is the UK 'request for debate' stage (to show the interest of the MPs of all parties)


 
Someday they could be talking about (choose your label) :
FECAL BODY ODOR
METABOLIC / SYSTEMIC BODY ODOR
MET-BO
TMAU
etc

It shows that politicians are very aware of M.E. and realise it is ignored.
Perhaps the same politicians who have sympathy with ME would be sympathetic to FBO.

What can be done ?
One could write their local politician about FBO etc.
e.g. MP, Senator, Rep, UK, USA, Canada, anywhere.

Also could look for politicians sympathetic to M.E. etc and write them.

Health systems and researchers are not interested in FBO/TMAU etc.
They need to be forced by politicians to act.

In UK
MPs make All Party Parliamentary Groups.
M.E. seems to have a group (2016) ME APPG

Full video :
Recent UK Parliament M.E. debate (in backroom, not main chamber)


Other awareness ideas :
Bus ad
Write to high profile 'TV Dr's/naturopaths'


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2 January 2018

Wevers & New Halitosis disorder : DMS and CH3SH

A new paper by Drs Wevers, Winkelman, Tanger et al, puts forward the theory that there is a newly discovered disorder that can cause metabolic/systemic halitosis.

The volatiles that cause the smells : DIMETHYLSULFIDE and METHANETHIOL .
Enzyme at fault : SELENBP1 .

title : Mutations in SELENBP1, encoding a novel human methanethiol oxidase, cause extraoral halitosis
Pubmed Abstract :  link
Full paper : Link

First impressions of this new paper/discovery :

1. IMHO it could be classed as the MOST IMPORTANT METABOLIC BODY ODOR DISCOVERY SINCE THE 'DISCOVERY' OF TMAU IN 1970.
The reason being that the concept of 'metabolic/systemic body odor' has relied on 1 compound (Trimethylamine) to prove the concept and be the 'sole' disorder, so more compounds to the list are welcome.
In a perfect world society would say 'let's now find all the metbo compounds' ... but society is not interested.

2. They feel that the gene to blame is SELENBP1 for this new disorder.
I still suspect FMO3 is to blame, so I will keep an open mind for now.

3. DMS and CH3SH are the compounds to blame for this disorder.
People with 'fecal body odor' (as it's known) complain of smelling of many nasty smells. To me, DMS and CH3SH are far better suspects for causing FBO rather than TMA, and they are probably in my top 5 list of potential FBO smell suspects, so to see them identified is very welcome.
I suspect there may be a few more (probably mostly Volatile Sulfur Compounds, thiols') suspects to add to the list, but I regard these 2 as potentially 'main players'.

My example list of FBO suspects (guesses):
Probably VSCs or Thiols ... e.g.

DMS
Methanethiol
Dimethyldisulfide
H2S
Cysteamine (?)
Way down the list .... TMA

When someone has metabolic BO, the 2 questions are :
1. What compounds are causing the smell ?
2. What enzyme(s) are supposed to neutralize those compounds.

So in this case I think they have identified bigger 'players' of the group of compounds that cause FBO, but wrong enzyme (could be wrong).



The 'urine' test for the new 'metbo disorder' : High Dimethylsulfoxide.
For the urine test they go for DMSO level.
Perhaps DMS and CH3SH are too volatile to rely on in a urine test, and may already have dissipated or altered. They seem to go for the OXIDE of DMS, which is perhaps the natural end product, and judge it on higher levels.
I would suggest this is definitely a test we should take.

About Wevers, Tangerman, Winkel et al :
The paper included the 3 above Drs, as well as many others. They have known to have a long interest in the causes of Halitosis, including metabolic causes.
That said, this paper may have taken 10 years (or more) to publish, so my 2 thoughts on their research are :
1. Whilst I welcome it, I am not relying on any breakthrough in society and Drs knowledge of met BO/hali in the near future.
2. I'm hoping perhaps they have 'stored' research and will announce treatments, test options, as a quickfire bundle of announcements this year, but I'm doubtful.

So in conclusion, my current view is :
Potentially 'top of the list' compounds identified to cause metbo body odor.
For now, I'm still a 'FMO3ist' rather than thinking it is SELENBP1.

Them :
compounds : DMS and CH3SH.
enzyme : SELENBP1

Me :
compounds : DMS and CH3SH (and a few more VSCs, thiols etc).
enzyme : FMO3   

Other potential metbo disorders :
I write mostly about my opinion as to the cause of FBO, which seems the main complaint.
I am sure there will be other metbo disorders, but these will be limited to perhaps 1 compound (or a small family), and to other genes.
FBO seems a wide spectrum of smells, so IMHO is most likely a 'broad spectrum' gene, whereas other metbo genes will have a  one distinctive smell (probably), such as isovaleric acid.   

What compounds make feces smell ?
Everyone knows the smell of poo can vary, so for the most part it seems that the compounds that make the smells are varying too. A guess would be they are mostly VSCs / Thiols, and a few other compound families thrown in. But for the most part they would seem to be sulfur compounds.
It may be a surprise to know the World Scientists do not yet have a definitive list of the compounds that make poo smell. Occasionally a researcher (such as Levitt et al) will do a few papers, but many might disagree with them.   

Media links to the story
Gizmodo
Medical Xpress
Science Daily
Genengnews
UCLA press release

Dr Wevers webpage

 

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20 October 2017

Could low Choline cause the smells ?

Spec thought :
Could LOW PLASMA CHOLINE cause the smells associated with FMO3 enzyme ?

For now it's a spurious idea, but I wonder if the smells associated with FMO3 enzyme weakness/overload might be caused by a LOW PLASMA CHOLINE level.
Probably not, but something to think about.

How could the person have low plasma choline ?
The gut bacteria break down the choline in the gut before it can be absorbed into the bloodstream.

Some things choline plays a role in :
Seems to play a role in brain function.
Deficiency seems to be associated with Fatty Liver.
It seems it is a main part of the mucus in the colon that protects the gut.   

Is any test lab bothered about Choline ?
It seems not.
So far, no lab testing choline plasma level can be found.
The health-system ignores choline testing.

So for now, this is a very speculative idea.
But a guess would be that even if not connected to smelling, 'TMAU' cases may be naturally prone to a choline plasma deficiency.





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5 March 2017

TMAU : Choline status should be tested

Campaign.
TMAU test protocol.
Add CHOLINE status as part of a 'TMAU profile screen'. 
Who to campaign to : National Health Systems.
My hope of success : currently about 5% ?

Currently those who think they have TMAU (trimethylaminuria) do the TMAU clinical test (the urine test). This tests levels of trimethylamine and it's oxide (TMAO).

It is known that choline is closely associated with TMAU. The theory is choline gets changed to TMA in the gut. This makes me wonder if TMAU people may often have a natural blood choline deficiency despite taking choline.

Choline currently seems to have a quasi status as an essential nutrient, Probably in time it will be regarded essential. It seems to be a good emulsifier of fats in the liver. This makes me wonder if TMAU people may be naturally prone to non-alcoholic fatty liver.

Many 'normal' people have NAFL, but it would be interesting to see what the % was in TMAU people. Maybe it will turn out low choline plasma is a cause.

Targeted TMAU profiles tests :
So my first 3 tests for a TMAU profile test would be :
TMAU urine test (I would do DNA test as well).
Choline plasma test.
Liver ultrascan (to look for NA- fatty liver)

Other speculative tests I can think of  (quickly written) :

Very speculative other tests for a TMAU profile :
Leaky gut test.
Ethanol test (to detect candida). Now no longer available (from Biolab UK).
Microbiome stool DNA test.
Biotin test (as I was once deficient in biotin).

I would add many others, but perhaps the first 3 are a realistic aim to convince conservative metabolic consultant for a TMAU profile.

Re ethanol test.
This was a test done by Biolab UK where you had to attend the lab. Ethanol is proposed as being generated only by yeast in humans.
I see now they have discontinued it, and refer people to do microbe organic test by Great Plains, which I don't think is as accurate (or at least, not a decade ago).  

Ultimate biochemical test for Systemic Body Odor :
A broad screen of volatiles known to cause systemic body odor. Currently they don't know the list of volatiles, so at this time this would be EXPLORATORY.
Once it was known what volatiles cause systemic body odor, they could then create a profile test with these volatiles.
Likely suspect volatiles (my guess) : dimethylsulfide, dimethyldisulfide, trimethylamine (small player).

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1 March 2017

New paper : TMAU might not just be FMO3 disorder

New TMAU paper by Monell et al.
Conclusion (?) : TMAU might not just be because of FMO3 enzyme.
Paper funded by NORD grant crowdfunded by TMAU community in 2011.

Around 2009-2011 a TMAU community group spearheaded a crowdfunding campaign to get the NORD TMAU grant past it's $25K trigger point so that researchers could put forward proposals for the grant. The grant was awarded in 2011 to a Monell Chemical Senses proposal. This month the paper has been published in a peer journal.

NORD grant TMAU paper : Genetic analysis of impaired trimethylamine metabolism using whole exome sequencing

Conclusions
Thus, variants in genes other than FMO3 may cause TMAU and the genetic variants identified here serve as a starting point for future studies of impaired TMA metabolism.

My interp of the paper 

My interp is they are saying genetic TMAU may not just be just to FMO3 enzyme flaws. In particualr they mention PYROXD2 enzyme, which has been mentioned in TMAU circles before (can't recall why).  

My own view on the paper (bad analogy ... suspects and safehouses)
If you think of 'volatiles' as the suspects, and FMO3 as the safe-house, they are saying the suspect (TMA) stays at various safehouses, TMA is to blame for all the smells, and only TMA should be followed about even when it leaves FMO3 'house' to other safehouses.

My own current view is the only safehouse to watch is FMO3, and note all the 'volatiles' that stay there. In fact I reckon TMA is a 'small player' and other FMO3 'safehouse' suspects are more likley to blame for smells. Probably the likes of dimethylsulfide.

So this new paper has went in a direction that doesn't fit with my current thinking, but it is 'new' in that they are suggesting TMA might be metabolized by enzymes other than FMO3 (?).

Paper view
Current Safehouse : FMO3
Suspect : TMA is only suspect.
Paper : TMA might have other safehouses.

My View
Safehouse : FMO3
Suspect : many. TMA a small player
My view : No need to follow TMA. FMO3 is only safehouse that matters, Keep an eye on the all suspects at FMO3 house.

Overall, I think so little research has gone into FMO3 and TMA that we may be at 'chapter 1' of understanding them. As this was a small one-off study, I don't expect much more 'TMAU' research on it. But since TMA has been suggested as having a connection with cardiovascular disease, perhaps TMAU people will be able to read on such research from this aspect in future.

Other comments on the paper :

None of the 10 people seem to report fishy smell. Most report 'sulfury'/fecal smells
My impression is that Monell feel TMA causes a fishy smell, but through influence have broadened this to saying TMA might cause smells more broader than that. Personally I think the smells are not due to TMA, but to other volatiles (e.g. sulfides), and in a way TMA is probably a 'small player' but a good biomarker of FMO3 function (? not even sure about that).    

Only one has FMO3 mutations that would be regarded by clinicians as TMAU1 
In academia and the clinical world, the teaching is that genetic TMAU is caused by serious FMO3 mutations. But in this paper only one has taught 'serious' mutations (at codon 148). Or at least, I think faults at 148 are bad. I note that they are not the worst TMAU result in the paper (at about 56%).

All the other FMO3 faults listed are carriers of common 'benign' FMO3 faults

Common FMO3 variants carried by whites by %  :
codon 158 : 20-50% ?
codon 308 -  up to 20% ?
codon 257 -  up to 15% ?

As can be seen, many people carry common FMO3 variants. Currently they are taught as being 'benign'. But in the paper, of the 10 tested, many of them only carry one of these FMO3 faults (mainly 158). Obviously 50% of whites don't have metabolic smells, so it's still an unknown full picture to understand.

The worst TMAU urine result seemed to only carry a PYROXD2 DNA fault.
In this paper, the worst result was #52 who only carried a fault in PYROXD2 enzyme.

Worst result in paper : #52 ... TMAO% output 13% ... FMO3 faults : none ... PYROXD2 faults : carries one

The worst TMAU result had no FMO3 faults and only carried 1 PYROXD2 fault. This throws up more questions than answers. 5 carried PYROXD2 faults (3 were homozygous, 2 heterozygous).

PYROXD2 faults listed : Not in coding part of PYROXD2
To make a PYROXD2 protein, you need an amino acid code. These are the codons on the exons.
Genes also have introns, which are generally regarded as 'junk' or unknown.
In this paper, the PYROXD2 faults listed are in the intronic region (not the exons). So they are not even in the coding part of the enzyme gene.

example of how gene makes a protein.
FMO3 has 532 amino acid code to make the FMO3 protein
this means 532 codons.
Genes also have intron part.
Introns not needed to form the protein, but faults there seem to be able to disable the protein.

PYROXD2 
This enzyme has been listed before in one TMAU paper. I can't recall at the moment.

Final thoughts 
The paper is certainly interesting in that it raises questions about current TMAU  teaching. How much impact it will have ... possibly not much due to lack on interest in TMAU.

I will be looking around at PYROXD2 again in a mild way. My mind is currently too set on FMO3 and all it's sulfide/amine volatiles, rather than TMA.

I have no expertise and my interp and thoughts could be wildly wrong.
My impression is Monell can be sensitive about opinions.

My own current theory on systemic body odor/halitosis
Most people identify with 'fecal body odor'. I think this is due to sulfides, maybe some amines. I think it is due to problems with the FMO3 enzyme. Probably often a combo of FMO3 slight weakness and 'FMO3 substrate gut dysbiosis'.

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12 February 2017

Youtube : Young lady talks TMAU & Fecal Body Odor


Saying it like it is.
Note about the video :
This is an embed of the original, not a copy.
If this original is deleted or 'sharing' is disabled, it will auto-delete here too.

Comment
Most people report of metabolic fecal/fart smells.
Currently trimethylamine is the only metabolite tested, so the only metabolite test on offer.
People with systemic malodors identify with the TMAU concept, but not the 'smell'.
There still seems a lot to discover about the 'systemic/metabolic malodor' syndrome.
Personally I think for most cases they have identified the correct enzyme but have limited it to one metabolite that may be a 'small player'.  

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19 January 2017

REACT TMAU Fund : spare a $5 ?

RE(ACT) rare disease site.
Meant for research crowdfunding.
Part of the BLACKSWAN charity.
Based in Switzerland.
Founded by pediatrician Dr Olivier Menzel.

Idea behind RE(ACT)
Rare disease groups can use it as a crowdfund site for research into their disease.
Researchers are supposed to put forward research proposals.
REACT has a expert committee who accept/reject proposals.
If no proposal is ongoing, the money goes in to a fund awaiting proposals.

RE(ACT) TMAU Fund
Throw them $5 ? (or EU/£ )
Problems with REACT
Staff seem to be not around.
Seems to be no users around.
Seems to be only one research fund ever raised of all the disorders.
Generally it seems neglected.
Yet they seem to do annual conferences.

REACT TMAU FUND : throw a $5 their way ?
Maybe if you have a spare 5 $/£/EU you could donate it to the TMAU Fund as a wake-up call.
Consider it money wasted.

Good things about REACT TMAU FUND
You can see the amount raised on their site.
Money does seem to at least stay in the fund (possibly forever).
Does not seem to get transferred into a general fund if deemed redundant.

SYSTEMIC MALODOR/TMAU community should have their research fund(s)
examples, Research Fund(s), campaigns such as awareness campaigns (e.g. Bus ad, conference) ).
Main ideas :
Needs to be transparent.
Needs to have broad support.  
Needs to be trusted etc.

Crowdfund campaigns etc
Examples : Individuals or small groups could start TMAU/Malodor crowdfunds.




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19 December 2016

Can FMO3 be induced by Korean mushroom ?

FMO3 experts teach that (in general ?) FMO3 cannot be induced or inhibited.
This is despite 'redox' enzymes often being induced/inhibited by foods/drugs/compounds.
A good example is a grapefruit compound greatly inhibiting enzyme CYP3A4 (discovered by accident).
FMO3 is known to be inhibited by certain indoles mainly in cruciferous veg (Cashman et al).
Also menstruation hormones have been shown to inhibit FMO3 (Cashman et al).
But still, the teaching seems to be that FMO3 cannot be induced/inhibited.

One view could be that so little is known of FMO3 (and perhaps other redox enzymes, but perhaps FMO3 is less important) that perhaps FMO3 can be induced/inhibited by compounds in food/drink/drugs. We don't know.

Paper : Korean herbal mushroom induces FMO3 
In a research paper last week, the authors seem to think they have shown that FMO3 can be induced by a Asian mushroom commonly used by Korean Herbalists.

Korean paper (University of Seoul, Seoul, Korea):
Korean herbal mushroom induces FMO3 in mice in research paper.
mushroom : Phellinus baumii

Quote :
"PBE was responsible for the induction of Fmo2, Fmo3, and Fmo4 expression. PBE also accelerated the metabolic clearance of carbendazim in vivo and so could be applied to the detoxification of xenobiotics such as drugs, pesticides, and nicotine."

pubmed link to abstract

My own view of this :
It's a one-off paper, perhaps biased to Korean herbal compounds.
I won't be looking to buy the mushroom.
The more I try herbal compounds, the worse I feel.
I think FMO3 was thought to develop in the animal/plant warfare fight, as plants developed poisons, FMO3 was developed to metabolize these (could be wrong),

But, it raises the question again about FMO3 INDUCTION as a possible therapy.

My main thought on this paper :
The notion that FMO3 INDUCTION may be worth exploring as a possible FMO3/TMAU therapy. This would be to say boost function by say 10-20%.
FMO3 induction would probably only be any use to those with FMO3 weakness/deficiency.

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11 December 2016

AIRE Breath Sensor for FODMAP

Foodsniffer (not the AIRE)
A start-up called FOODMARBLE is launching a breath sensor.
Called the AIRE Breath Sensor.
It is designed for the FODMAP diet.
Detects : HYDROGEN levels ?
Hydrogen is thought to be the main gas given off during gut fermentation.
Hydrogen is used as the gas tested for 'small intestine bacterial overgrowth'.

Possible interest to those with systemic body odor/halitosis :
The blog current view is that FMO3 enzyme may be the weakness for most type of SYSTEMIC BODY ODOR (SBO).
Many of the gases from gut fermentation are probably FMO3 substrates (e.g. certain sulfides/amines).
Many with 'fecal body odor' feel they have 'gut dysbiosis'.
Something like the AIRE may help them track their 'dysbiosis' via hydrogen level.



Initial thoughts about the AIRE :
It's version 1. With hindsight it may be regarded as not very good.
BUT, people with SBO will for the foreseeable future need 'sensors' (probably breath sensors).
If it worked, it may be of some use to track 'gut dysbiosis'.
The platform (device for phone, bluetooth etc) is ideal for the consumer. A SBO sensor will be probably the same (but detect different gases e.g. dimethylsulfide).
Great price ($99 intro price). At that price it's worth a gamble.
(note : I already bought the 'foodsniffer' and 'mint breathometer' (not arrived after 2 months), so will probably not be buying the AIRE soon).

AIRE Sensor website
Twitter
Daily Mail (dec 16)
Press Release (dec 16)
Business Insider (may 16)

Systemic Body Odor needs a Consumer Sensor :
SBO will need it's own version(s) of a 'sensor'. Once it's known what gases act as biomarkers or to detect all the types of gases that cause SBO. A good 'suspect' would be 'dimethylsulfide'.
Currently such a sensor does not exist for systemic body odor.
Partly as the technology had not reached a decent level yet.
Also it seems sensor makers are only realising there was a consumer market for say 'halitosis' sensors, or hydrogen sensors. More because of start-ups getting in the market via crowdfunding.
with SBO, the person usually cannot smell themselves (my opinion, they are usually transient and the brain ignores it's own circulating smells).

One thing is for sure, SBO will need a sensor that detects SBO gases.
Currently we do not know what these gases are (apart from trimethylamine).
It's likely sulfides like dimethylsulfide will be suspects.

Fecal Body Odor :
Probably it's unknown exactly what gases make fecal smells.
Scientists will have a good idea of suspects, but papers are few and contradictory.
Perhaps for SBO, there may be a wide spectrum of sulfides/amines at any point, but perhaps a handful of 'big players' (e.g. dimethylsulfide) which could then act as 'biomarkers' for a sensor.

Possible 'big players' for Fecal Body Odor (guesses) : 
dimethylsulfide
dimethyldisulfide
methanethiol
cysteamine

FINAL THOUGHTS
The SBO community will need their own 'sensor' as they are 'nose blind' to their own smells.
The tech (and makers will) has not been there for consumer sensors.
But over the last 2 years, both the tech and now we see the will, for consumer sensors is happening.
No sensor maker would currently probably invest in a 'SBO sensor', thinking there is no market.
But other sensors may longterm make the process cheaper.
Many with SBO feel they have 'gut dysbiosis', so a sensor like the AIRE may be worth a gamble.
Keep in mind for AIRE it's version 1 (i.e. early days).  

What SBO needs
1. To find out all (or at least the main) volatiles that cause SBO (exploratory tests).
2. From that info, a diagnostic test.
3. A Sensor(s)
4. A DNA test (probably being superceded by exome/genome tests which are mathing price of single gene tests).
5. Therapies/cures.


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4 November 2016

marine trimethylamine : a big source of greenhouse gas methane

It seems that trimethylamine produced in marine environments is often broken down to methane.
Methane is a main gas that cause the 'greenhouse effect' (Global warming).
Perhaps this is another reason for scientists to look at ways to block TMA formation.
Which in turn could lead to a therapy for human gut TMA formation.

TMA produced in marine environments : 
I only heard of this TMA connection. Probably marine microbes produce TMA. Apparently the TMA is broken down to methane, which is a major part of the gases that cause global warming.

I have tried to look for the % stats for sources of greenhouse gases, but not been too successful.
One site said

% methane makes up greenhouse gases : 16% (2nd after CO2).
% of NATURAL methane sources are marine : 88% (78% wetlands, 10% sea).
This does not include HUMAN sources (e.g. petrol, coal, farming).

I would guess the marine TMA is a by product of microbe fermentation, which then is broken down to methane. Ironically this has been suggested as a possible therapy for TMAU, in that some microbes would break down the TMA in the gut. I guess so few are thought to have TMAU it would not add much to the total world methane output.

But ... this means it's in the world's interest to find TMA blockers, so that TMA does not produce methane. This would probably mean interfering with the enzyme that produces TMA. Antibiotics are often 'microbe enzyme inhibitors', so it's much the same thing as antibiotics.

So maybe there is research going on to prevent methane formation from TMA to save the planet.

3 main ways TMA could be inhibited or broken down (I know of) :
1. Interfering/inhibiting the microbe enzyme that produces TMA (antibiotics often work this way).
2. 'Drugging the relevant microbes'. This seems to be the Cleveland method. They are tricking the microbes into working on a compound that is like choline but much more dificult for them to breakdown.
3. Use microbes to break TMA down via the methane pathway. Some microbes have enzymes that can break TMA down.

My thoughts on TMAU and systemic body odor
Any therapy that inhibited TMA formation or broke down TMA (e.g. to methane) would be good for anyone who thought their smell(s) were solely created by TMA. I am a bit sceptical that TMA is the only source of smells for most, so a bit worried such a therapy would not have the expected benefits. But I may be wrong.

Acronynms :
TMA : trimethylamine
TMAU : trimethylaminuria

Note :
graph and stats may be incorrect.
    

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25 October 2016

Bacteroidetes don't produce trimethylamine from choline

 2012 paper suggests bacteroidetes phyla are poor at degrading choline to trimethylamine.
Firmicutes, Actinobacteria, and Proteobacteria can produce TMA.
Ubiome suggest Firmicutes make up 60% of normal flora, Bacteroidetes 30%.
My own Ubiome results average (of 4) were Firmicutes 70%, Bacteroidetes 26%.
My own opinion, not enough known of the gut flora for me to have an opinion.
This post more a 'for your information' post, rather than any 'breakthrough'.
Perhaps others should try stool DNA testing.

The new Phillips/Shephard TMAU-FMO3 overview paper mentioned a 2012 paper which they seemed to have great credence for. The research in the paper proved TMA could be produced from choline by certain gut bacteria flora phyla (Firmicutes, Actinobacteria, and Proteobacteria) but not from Bacteroidetes.

Quote from Phillips/Shephard/Fennema paper

Free choline is absorbed throughout the small intestine and is subsequently integrated into cell membranes or actively taken up by the liver, where it can be converted to betaine, phosphocholine, or lecithin (Zeisel, 1990). High amounts of choline may exceed the absorptive capacity and pass through to the large intestine, however, where it is metabolized to methylamines by microbial action (Zeisel et al., 1983). Choline is a quaternary ammonium compound containing a trimethylammonium moiety. Thus, it can act as a precursor for TMA (Zeisel et al., 1989; Chalmers et al., 2006). The bacterial conversion of choline to TMA involves the cleavage of the carbon-nitrogen bond of choline, producing TMA and acetaldehyde (Hayward and Stadtman, 1959). Craciun and Balskus (2012) proposed that a glycyl radical enzyme CutC (EC 4.3.99.4), encoded by the bacterial choline utilization gene cluster (cut), might act as a choline TMA-lyase to catalyze this initial step in choline degradation (Fig. 1). This was confirmed by demonstrating that deletion of cutC in Desulfovibrio desulfuricans abolished the ability of the organism to produce TMA from choline. Bioinformatics analysis revealed cutC homologs in 89 bacterial genomes. The homologs are not distributed evenly among the major bacterial phyla of the human gut, being present in Firmicutes, Actinobacteria, and Proteobacteria spp. but absent from Bacteroidetes (Craciun and Balskus, 2012). Table 1 shows bacteria known to be associated with formation of TMA via choline degradation.

This is the paper they refer to :
Microbial conversion of choline to trimethylamine requires a glycyl radical enzyme

Firmicutes and Bacteroidetes seem to make up the bulk of the gut flora. There seems to be different opinions on what that % make-up should be for a healthy gut.

Ubiome suggest the healthy gut should have about 70% Firmicutes and 30% Bacteroidetes.

My own Firmicute/Bacteroidetes ratio :
I have tested with Ubiome 4 times.
In 3 samples my Firmicute was slightly higher than normal. Bacteroidetes was slightly lower.

My view on the knowledge of the human gut flora :
I would suggest if you compare it to the history of USA, it may be around the year 1620. Perhaps I'm wrong, but my impression is so little is understood of the gut flora (Oct 16). I'm hoping technology has caught up and we will be at around year 1900 in the next few years.

My view on my own results :
I will not be excitedly trying to alter my firmicute/bacteriodetes ratio, though may look around for info. It seems that bacteroidetes are not the type usually put in 'probiotics'. Possibly partly as they are so 'sensitive' (and die easy in oxygen). Possibly there is no 'bacteroidetes' probiotic on the market. The general view seems to be taking 'prebiotics' is the best hope of feeding bacteroidetes.

Perhaps others can do the stool DNA test :
Since the stool  DNA test is relatively cheap, and sometimes they do special offers (e.g. 3 for 1), perhaps others with systemic body odor/halitosis can do the test and mention anything they want about the results in the comment section of this post.

Stool DNA test suppliers :
Ubiome (choose citizen science)
American Gut (also 'UK Gut')

These are the 2 best known suppliers. Thankfully, they are consumer health friendly, and not health learning obstacles as is the case with normal DNA tests, urine tests etc. The spirit of the testing would be that it may be not very useful, but perhaps will be in hindsight.    

What's this to do with systemic body odor ?
My own view is that most cases of SBO are probably due to enzyme weaknesses, probably the bulk of which are due to sub-par FMO3 enzyme function. But I also think gut dysbiosis will be a common factor in 'FMO3 body odor', probably as part of the syndrome, and perhaps often the 'tipping point'.

Currently TMAU is the only acccepted form of systemic body odor. My own view is that 'FMO3 body odor' can mean smelling of any FMO3 substrate rather than just TMA, and many of the volatiles produced in the gut are probably FMO substrates. Although this paper was about TMA, perhaps bacteroidetes can't produce other FMO3 substrates, but who knows.

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17 September 2016

Mint Breathometer ... to detect stinky breath

Mint Breathometer app and device to detect halitosis.
Available in USA from 30th Sept 2016 (can pre-order now).
$100.

The systemic/metabolic body/breath malodor community usually cannot smell themselves when they smell, so I have thought a phone based 'odorometer' is as essential as therapies and 'clinical' tests. I have looked around for leads and found no company to view it is likely profitable. This was frustrating as I figure the 'bad-breath vanity' market for say 'halitophobia' would be as big as mouthwash, and quite often they may check for some 'volatiles' that may be common to the main type of  systemic body odor (e.g. mercaptans, hydrogen sulfide etc).

It was inevitable that phone breathometers would come along, although this 'version 1' breathometer seems the first one and only one available. Perhaps it has also taken the technology up until now to catch up with the concept, and even now it's probably pretty new and probably subject to many changes until the tech matures.

links :
Breathometer site
Indiegogo : where Mint breathometer started
Mint Breathometer article in Techcrunch
article in Venturebeat (9/16)

Charles Yin is the 'tech entrepreuer' who owns the company. So far he found riches in 2 tech companies (selling them. Not sure if they are still around). Now he doesn't need money.

He appeared on 'Shark Tank' looking for funding for a 'phone alcohol breath sensor', which all 5 sharks gave money for (a bit worrying imho. I would want the publicity but not their stake). A 'breath alcohol phone sensor' sounds not very interesting to me, as there are so many small breathylyzers around.

It seems now they have dumped the 'alcohol breathalyser' and are focusing on detecting all kinds of volatiles that may be related to health. And as I say, the halitophobia vanity market is probably huge and this seems their current focus.

Philips
It seems that Philips are now involved, meaning the tech will have unlimited funding/research, and this means it's probably a long-term part of their oral healthcare strategy.

Relevance to Systemic Body Odor
My own feeling is that those with SBO tend to emit the volatiles through every part of our body, and the breath is probably a good indicator. Some feel they have Systemic Malodors only through their breath. Personally I feel my main problem is SBO, but even then there may be a higher than normal amount of volatiles in my breath when smelling.

The SBO community needs a sensor device as much as therapies, clinical tests etc, and currently this seems the nearest to the aim of a portable sensor for SBO. It looks like it tests for the common VSCs they look for in 'traditional localized halitosis'. I am sure one or more of these will be common in SBO (suspects like sulfides).
And at the moment this is really the only sensor on offer.

Foodsniffer
This device became available about 2 years ago. Again starting on indiegogo (possibly to test the market) then going 'professional'. This is meant to tell you if food is spoilt, about to spoil, or fine. I bought one and it does seem to sense something (e.g. I tried over a bin). It was also pretty good tech overall imho (bluetooth, nice app, well made device).
But I have little to no confidence in it to monitor SBO (as it wasn't intended to).

Mint Breathometer worth buying for SBO ?
For SBO, I would put this down as an 'exploratory gamble buy' that may obviously not be useful after a day or 2 (for SBO monitoring). But currently we have no choice so I'm thinking it's better than nothing.
It's on the right trajectory for SBO, but not quite designed for SBO. Personally I think the 'SBO' market itself will be huge (my estimate, 1% population 'at risk', or would at least buy a sensor). The 'halitophobia' market will be even bigger. I would guess almost everyone worries about halitosis.            

         

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3 September 2016

TMAO and Alzheimers ? (new paper)

New paper.  Since 2011, Trimethylamine-n-oxide has been postulated by a Cleveland Clinic paper as having a connection with atherosclerosis (and so Heart Disease). Before this 2011 paper trimethylamine metabolism in humans was ignored. Since then it has been suggested as possibly having a role in many of the worst health problems in humans.

List of diseases postulated as having a possible connection with TMAO (so far, all since 2011) :
Diabetes.
Chronic kidney disease.  
Atherosclerosis (e.g. heart disease, stroke)

And now, a paper postulates that TMAO may be associated with Alzheimers (Alz) :
Paper : TMAO and Alzheimer's
Xu R, Wang Q
Dpt of Epidemiology and Biostatistics, Institute of Computational Biology, School of Medicine, Case Western Reserve University, Cleveland
ThinTek LLC, Palo Alto


Context of the paper (my view) :
Seems to be a 'computational' look at microbiome stats to look for a connection between gut microbiome compounds (only) and Alz. The conclusion seems to be TMAO could be of interest as a biomarker. 
I have not heard of the authors or labs. 
It should be kept in mind that it seems pretty speculative (for now) and many of these types of papers are put out, often contradicting.
I'm not thinking it's correct or false or significant (yet).
Quote :
We identified common genetic pathways underlying AD biomarkers and its top one ranked metabolite trimethylamine N-oxide (TMAO), a gut microbial metabolite of dietary meat and fat. These coregulated pathways between TMAO-AD may provide insights into the mechanisms of how dietary meat and fat contribute to AD.
What's this to do with systemic body odor ?
Currently the only volatile tested for SBO is trimethylamine (TMA), and the only documented SBO is trimethylaminuria (TMAU). Until 2011 there was no interest in TMA metabolism in humans. Now since the CVD-TMAO theory (and other diseases), TMA metabolism is of great interest. This co-incidence is very good news for those who feel they have TMAU only (i.e. only smell of TMA), as it means great interest in TMA metabolism and will likely lead to 'therapies'. P&G already have a deal with Cleveland Heartlab to produce an over-the-counter 'TMAO-management supplement' (at a guess, a 'TMA-blocker pill'. It is not known when.

My own view :
Currently I suspect that FMO3 enzyme is the right enzyme highlighted as being the main 'SBO enzyme', but that the smells are not limited to TMA. So I am a bit cautious about hoping 'TMA cures' will mean 'SBO cures', but will be buying any TMA therapy by the crate.
I currently have no opinion the 'TMAO connection theory' to diseases, but grateful for all the attention/research to TMA metabolism.


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31 July 2016

Metabolomic Profiling for Systemic Body Odor

This post is meant to be thought provoking.

Need to discover all volatiles/metabolites that cause systemic body odor.
Once discovered, these volatiles will be known as the biomarkers for the diagnostic test,

Trimethylaminuria (TMAU) was 'discovered' in 1970 by Denver Dr's. A patient's mother had said sometimes their child smelt of fish (they had another serious disorder) and the Drs decided to test the TMA level since they knew this volatile smells of fish.

So the only volatile currently tested for systemic/metabolic body odor came about in an anecdotal case and no-one has looked any further than this since (that's if they even look for TMA). It goes to show how much 'sufferers' need to further the understanding of systemic body odor themselves, as no-one is looking.

Personally I think maybe 1% population could be 'prone' to  transient systemic body odor, probably 'fecal body odor'. Maybe even more. I would guess it may well be the biggest 'undiscovered' metabolic disorder left.

Metabolome Testing
It's only about 18 years since the FMO3 enzyme DNA code was fully documented. So genetics is still at a fairly new stage. Along with genetics, the other science that compliments it is human metabolomics, the study of the metabolites in humans. Again this is a fairly new science, both in knowledge and the technology needed. It does seem to be maturing now.

Metabolomics for understanding systemic body odor
When a disorder is fully understood it will have a 'phenotype' test where they look for the known biomarkers in human fluid to see if the person has the disorder. Since the concept of systemic body odor has not been documented, it will currently need a test like an exploratory metabolome test to look for higher levels of metabolites (probably volatiles). Once they document the biomarkers for systemic body odor, you can then use these biomarkers as the 'disorder test'.

How to do a Metabolome test
First you need to make sure it will look for the 'suspect' metabolites. In the case of SBO, these will probably be sulfide volatiles, but I wouldn't rule anything out for now. I would guess most labs would do a very broad spectrum exploratory test.

examples of 'suspect' volatiles I would look for in systemic body odor :
dimethylsulfide
dimethyldisulfide
methanethiol

Personally I would be looking at FMO3 substrates, as I reckon this enzyme may be to blame for the biggest group of SBO sufferers.

Ease of testing
Since it's a new science, I am unsure of how many labs do metabolomic testing. It's probably not a regular in the mainstream medical health industry (e.g hospitals). Probably more a test done at University labs where trends for testing probably start off.

Also, as usual most labs will probably insist only a Dr can order the test. The usual obstacle to testing used in the medical health industry. Hopefully someday the law will change to allow people to self-pay any test.

Testing Centers :    
Looking around I am not aware of too many potential test centers. A quick google search came up with these possible leads :
Uni of Alberta
Baylor Clinic
Human Metabolome Technologies (Boston)  

The system :
I would say at the moment, expect the system to be against you.


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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
link

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