4th WebinarDr Richard Mackay, FRACP, FRCPA, Clinical Biochemist at Canterbury Health Labs in Christchurch New Zealand for his informative lecture on Sunday, December 2nd, given to our community at 8:00 am on a Monday morning his time!
Dr Mackay gave us a biochemical explanation on the metabolism of trimethylamine (TMA) and trimethylamine oxide (TMAO) from the point of ingestion through the small and large intestines to the kidneys and urine. When TMAO (from fish) and choline betaine is consumed, some choline betaine is absorbed by the small intestine and goes in the portal blood to the liver. Some of the choline betaine and TMAO continue on to the large intestine and colonic bacteria converts both to TMA (odorous chemical), which also travels in the portal blood to the liver, where it is converted into TMAO (non-odorous state) by FMO3 enzymes. When there is a deficiency of FMO3 enzymes, odorous TMA goes into the main bloodstream and is excreted in the urine.
Dr. Mackay discussed...the use of instruments, such as Gas Chromatography, Liquid Chromatography, Mass Spectrometry, and Nuclear Magnetic Resonance (NMR), and how they are all equally accurate for testing TMAU.Dr. Mackay discussed the various tools and methods used around the world to perform the TMAU Test, from describing the loads used, including fish, choline, or trimethylamine pills, to the instruments used for analysis. He explained in some detail the various methods used for testing human samples with the use of instruments, such as Gas Chromatography, Liquid Chromatography, Mass Spectrometry, and Nuclear Magnetic Resonance (NMR), and how they are all equally as accurate for testing TMAU.
An interesting point he made is that in the case of TMAU, all seafood should be avoided because it contains TMAO that is converted into TMA by colonic bacteria, other than tuna, which does not seem to contain TMAO. In addition, foods rich in choline betaine and carnatine should also be avoided because bacteria in the gut also converts these into TMA. Dr. Mackay concluded his presentation with a very interesting discussion on the genetics of TMAU.
At Dr Mackay's request, this webinar was not recorded.
Dr Mackay is the lead author of the publication, Trimethylaminuria: causes and diagnosis of a socially distressing condition.
Our thanks goes to Dr Mackay for his excellent presentation, to Rob Pleticha for hosting this webinar, and to everyone who joined in and raised interesting questions.
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