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March20 podcast Dr Hazen
anti-TMA pill in a year or 2 ? (scroll 12 mins)

Additional info:
MEBO Karen
at UK Findacure conf 2020

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MEBO Map Testing & Meetups

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MEBO - UBIOME study 2018



MEBO Gut Microbiome Study
"Microbial Basis of Systemic Malodor and PATM Conditions (PATM)"
Funded by uBiome Research Grant

"Microbial Basis of Systemic Malodor and PATM Conditions (PATM)"

Dynamics of the Gut Microbiota in
Idiopathic Malodor Production

Started May 2018 - Ongoing

Current people sent kits : 100/100
3 kits per person


Participation info : LINK English

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BO Sufferers Podcasts



TMAU Petition world
TMAU UK end total:262
TMAU UK ends 23/01/20
TMAU Petition USA end total 204
USA : Moveon open
TMAU (Dominican)
Metabolomic Profiling Study

Start : Aug 2016
Stage 1 : 27 Canadian volunteers to test
Latest click here (26 oct) :
17 samples returned

Note : Stage 1 is Canada only.
Return cut-off date : passed
Analysis can take 6/8 weeks
Analysis start in/before Nov
MEBO Research is a
NORD Member Organization
See RareConnect TMAU

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MEBO Metabolic Malodor Survey (international) for Dr Hazen click here
click to Read more/less

survey for ANYONE who identifies with METABOLIC MALODOR

begun : Oct20
end : no ending for now

Regular readers will know that Dr Stan Hazen et al at Cleveland Clinic are developing a TMA-blocker pill, as they proposed in a 2011 paper that TMAO is a factor in CVD. Recently Dr Hazen and colleagues contacted MEBO as they have always thought they could also help with TMAU. This survey is to give them an idea of the 'state of the community'. It is a "version 1". They may not even look (though they have access permission), but it could be useful to give them an overview of the community

MEBO had a zoom call with Dr Hazen and his team in October. Another zoom call is planned when they have time

This is a GOOGLE FORMS survey

short url for survey :

current participants : 113 (update 18dec20)

Monday, July 14, 2008

Secondary TMAU (precursor overload) and testing

It appears to me that the concept of Secondary TMAU caused by precursor overload and/or bacteria overgrowth seems to be only ever mentioned by people tested in the UK, although I am open to seeing documentation to the contrary opinion. I have looked for articles written by US experts supporting this concept described by UK experts, but have not found any so far.

There are so few researchers in trimethylaminuria, and it seems unclear if there is international agreement as to how the guidelines for the testing results parameters for the urine is determined. This is something we need to clarify as a 'community'. Based on the literature I've come across, it appears that in the UK, the few TMAU experts seem to accept that overgrowth of the bacteria that produce trimethylamine can itself be the problem (saturating the normal fmo3 enzyme), even if the fmo3 enzyme is fully functional. They call this 'secondary TMAU' or 'precursor overload'. There doesn't seem to be reported cases of this in the USA or elsewhere. It's something we as a community need clarification on. Of course people can have both primary and secondary (enzyme function too low, and too much bacteria), but it is interesting that a group of experts are willing to accept 'overload' alone can be a cause, whereas so few (if any) elsewhere seem to mention secondary TMAU.

It appears to me that this means at least some experts accept the principle of 'overgrowth' being a potential cause.

In this case (if the assumption is correct), the patient only seems to be positive for secondary TMAU in the urine test, and consequently they conclude he is positive for primary TMAU from the DNA test.

The following is a quote from a paper written by experts who accept (perhaps introduced) the concept of Secondary TMAU :

"Substrate overload of FMO3 enzyme activity resulting from either an excess of dietary precursors of TMA or variations in gut fauna, causing increased release of TMA. This type of trimethylaminuria is characterized by a high concentration of TMA in the urine, but a normal urinary TMA/TMA N-oxide ratio."

So it raises the question; has anyone in the USA or anywhere apart from the UK been tested for 'secondary TMAU' ?


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