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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

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Denver TMAU Test Lab survey click here
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USA survey for anyone who wants to improve Denver TMAU test

begun : Dec22
end : no ending for now

A trainee genetic counselor is working at the Denver TMAU test lab. Probably as part of her training. As a project she wishes feedback on any aspect of the Denver TMAU test and process. You can fill in the survey and/or email her (email address is in survey). It's meant for USA people, but perhaps others can give their view too (as we have so few opportunities).

quote from her rareconnect post

"Hello all! I wanted to make you aware of a research study being conducted to better understand the experience and needs of individuals with trimethylaminuria with a goal of being able to create improved patient and healthcare provider education materials. Any participation is completely voluntary and all responses remain confidential. Feel free to use the contact information within the link with any questions or share the survey with others with TMAU."

see this post for more details

Friday, February 27, 2009

Interview : Mark Howard of Biolab Medical Unit, London

While the mainstream medical system may be regarded as the best option for obvious and well-documented health problems, it does not appear very good at dealing with health problems it cannot diagnose or doesn't know about, such as bloodborne body door and halitosis. This explains the existance of niche labs such as Biolab in Central London, which specialises in tests that the mainstream system do not test for, in ways that are just as stringent, such as vitamin/mineral status, and other insightful biochemical tests. They seem to uniquely be the only testers for 'fungal-type-dysbiosis' using ethanol as the marker (after a glucose challenge in a controlled setting). Ethanol is thought to be only produced in humans by fungus. They also use PEG400 as the detector of 'gut permeability', rather than lactulose and mannitol that other labs use. PEG400 can tell more information about gut permeability.

Their website states:

Biolab is a medical laboratory specialising in nutritional and environmental Medicine. We measure mineral and vitamin levels, toxic metals, other biochemical levels that are related to the availability of vitamins, minerals and other nutrients, and we also have an extensive range of profiles for assessing the effects of Twenty-First century lifestyles on our bodies (Tests).

The laboratory is staffed by a highly qualified team and participates in a number of quality control schemes. Many of our tests require expensive high-tech instrumentation and are not normally available at other pathology laboratories. Routine pathology investigations and allergy tests are referred to other laboratories.

However it must be kept in mind that bloodborne odors will likely be an unknown condition even to innovative labs such as Biolab, but nevertheless the tests they do will perhaps be a better bet than the main health system in providing clues into bloodborne odor syndromes (such as fecal body odor) in the long-term.

The following is PART ONE of a 2 part email interview with Mark Howard, Biolab manager, about this pioneering niche lab.
Part 2 is here


* What is the philosophy behind Biolabs existence ?

Biolab was launched in 1984 as a nutritional biochemistry laboratory offering a range of tests of nutritional status for doctors; tests which were not available elsewhere. With the assistance of our referring doctors our aim was to encourage the medical community to consider nutritional and environmental factors in their assessment of patients.
Our primary philosophy is to assist every doctor and patient to achieve optimum wellbeing by providing access to biochemical assessments that are otherwise unavailable. We are led by our patients and doctors.

* Would you say the tests at Biolab are examples of important missing parts of the main health system ?

We believe it is not possible to adequately assess a patient and provide optimum recommendations without a detailed assessment of lifestyle factors. Biolab provides doctors with tools to assist them in this approach, the majority of which are not available in routine pathology laboratories.

* Are there health problems that the mainstream health system regard as burdens one must bear, that Biolab tests show may be very treatable (e.g. arthritis) ?

The majority of patients undertaking Biolab investigations are those who have not made adequate progress using “conventional” approaches. Many of these patients benefit enormously from correcting nutritional deficiencies, identifying allergies and intolerances to foods and other substances, and quite frequently we find other biochemical abnormalities that have not previously been addressed. I have attached a paper written by our Medical Director, Dr Stephen Davies, that offers an explanation of how our approach can improve an individual’s capacity to deal with illness (i.e. we believe most illnesses develop as a result of decreased adaptive capacity).

pdf file: Dr Stephen Davies article Adaptive Capacity

Bloodborne body odor and halitosis

* Bloodborne body odor/halitosis seems to currently be an unknown problem, apart from trimethylaminuria. Given that the syndrome(s) isn't defined yet, do you have any overall thoughts on the problem, and suggestions as to what 'test' areas to look at ?

Specific approaches will depend on many factors (clinical history, environmental & lifestyle factors, genetic predisposition etc. etc.). There are of course many possible avenues to explore including gut problems ranging from bacterial/yeast overgrowths (fungal type dysbiosis) to digestive problems and possibly increased gut permeability, endocrinological problems, other microbacteria or biochemical abnormalities and problems arising from inappropriate diets. Most doctors using Biolab would undertake a thorough clinical, dietary and lifestyle assessment and would initially check all the routine haematology and biochemistry, assess micronutrient levels (as an indicator of dietary adequacy and absorption, and also as a guide to increased demands for certain micronutrients), consider food allergies (and sensitivities) and assess gut condition. They would also consider exposure to environmental chemicals and toxic metals, which can cause significant disruption to normal physiology.

* Have you heard of bloodborne odor problems or even had patients attend the lab with odor

Over the years we have seen a number of patients with odour related problems, but in most cases the cause has been identified as of dietary origin, gut dysbiosis, hormonal problems (resulting in profuse sweating), and of course diabetic ketoacidosis.

* Do you think 'classic' external armpit body odor could be to do with an internal problem ? (e.g. low zinc)

Assuming that adequate and appropriate personal hygiene is in place, then abnormal biochemistry could lead to profuse sweating, sweat with abnormal chemical composition, or the presence of unusual compounds in the sweat, all of which could lead to unusual body odour. It’s theoretically possible that variations in the chemical composition of sweat could affect bacterial growth rates, but thisis purely hypothetical and I do not have any specific details on this.


* Is gut candidiasis a common problem ? Do you think it is 'overhyped' as a health issue (do you have an estimated ratio of candida dysbiosis compared to other dysbiosis alcohols tested for ?)
What is your highest candida-sourced ethanol reading ?
* Do people with gut candidiasis often fail other Biolab tests ? Is there a trend ?
* What sort of health problems or symptoms do you find associated with candida overgrowth

Candidiasis may not always be a mistaken diagnosis, but our test is not specific to candida albicans so all we can definitely say is that there is fungal activity. Stool analyses can determine the type of fungus, but the treatment strategy is the same whatever.

It’s not possible here to give a comprehensive answer to all of these questions, but yeast (not solely candida. Our test is not specific to candida albicans so all we can definitely say is that there is fungal activity. Stool analyses can determine the type of fungus, but the treatment strategy is the same whatever) and bacterial overgrowths in the gut appear to arise quite frequently in sick patients, either due to a compromised immune system or long-term antibiotic therapy that disrupts the gut flora. Our gut fermentation profile detects alcohols in the blood as a result of fermentation of glucose in the gut 1 hour after the ingestion of 5g of glucose following a fast and abstinence from alcohol beverages. I have attached a copy of our test datasheet for this test for your interest and a further article on “Fungal Type Dysbiosis”.

pdf file: Gut Fermentation Profile
pdf file: Fungal-type dysbiosis

It is wise for all clinicians to suspect abnormal gut flora if the symptoms suggest this until proven otherwise through testing, dietary changes and/or appropriate antifungal therapy. Increases in blood short-chain fatty acids and some alcohols other than ethanol may indicate bacterial overgrowths (whereby breath hydrogen and breath methane measurements may be suggested), or urea breath tests for helicobacter pylori. We don’t frequently see evidence of bacterial and yeast overgrowths at the same time, but it does happen sometimes.

Dysbiosis and Leaky gut

* Does leaky gut mean 'leaky small intestine' ? What are the common reasons for leaky gut ?
* What are the spectrums of problems you think possible with leaky gut ?
* Why do you use the PEG leaky gut test rather than lactulose/mannitol test that other labs use ?
* You test for other alcohols in the gut fermentation test. Do you find often that candida sufferers also have those alcohols increased too ?
* If someone has no candida problem but the other alcohols are raised, what sort of health problems do you expect they could have ?
* Are there other Biolab tests you suggest for dysbiosis ? (e.g. vitamin status tests)

Some of the above questions were answered in my previous response.
Increased gut permeability, primarily of the small intestine, can occur for many reasons (gut infections, food reactions, impaired digestion etc.). Health problems resulting from increased gut permeability are wide ranging because there can be an immune response when food is absorbed before complete digestion has occurred, micronutrient deficiencies can develop if the gut is not functioning properly and short-chain polypeptides (resulting from incomplete protein digestion) can mimic hormones, disrupting metabolic processes. At Biolab we can measure gut permeability by looking at the absorption profile following ingestion of a substance with a range of known molecular weights (we look at the quantity of each molecular weight excreted in the urine) and we also measure blood levels of short-chain polypeptides. We are currently expanding our research work in these areas and hope to offer even better tests in the coming months. The benefit of using PEG 400 (polyethylene glycol) in our profile is that it gives us a wide range of molecular weights to assess thereby providing a more comprehensive profile of gut permeability than the sugar challenge tests that are commonly used. This is useful in assessing the severity of increased gut permeability and also for monitoring treatment progress (which can be problematic due to the mult-factorial nature of the problem).
When gut dysbiosis has been diagnosed it is important to assess all aspects of nutritional status as adequate dietary absorption is likely to have been impaired for sometime. As dietary analysis isn’t going to provide all the answers, laboratory testing of mineral, vitamin and fatty acids levels is important to identify any deficiencies that need urgent rectification, or that are going to be difficult to correct with diet alone.

Part 2 here


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