In her interview posted in this blog of March 24, 2009, Cass Nelson-Dooley, M.S, Clinical Consultant at Metametrix Clinical Laboratory, with contributions by Mr. Tony Hoffman, tells us of the very important role of anaerobic bacteria that dwell in the colon or the vagina that produces smelly compounds like trimethylamine (TMA) and hydrogen sulfide, as opposed to them being products of human metabolism.
The first thing to do is lower protein intake and improve protein digestion to reduce undigested nitrogenous substrates (amino acids) that must be present to form ammonia.A very small percentage of the human population is diagnosed with Primary Trimethylaminuria, which is caused by a genetic disorder. Yet, many people who test negative for TMAU have the same or similar odor as a person with TMAU. Moreover, persons who test positive for Primary TMAU don't smell only of fish but also of other odors as well. This is because bacteria is the culprit that produces multiple types of volatile organic compounds (VOCs). As Cass Nelson-Dooley points out in her interview,
...The more smelly compounds like trimethylamine and hydrogen sulfide are not products of human metabolism, but they are produced by several bacteria under certain conditions. They tend to be strict anaerobes that could dwell in the colon or the vagina.
Some feel that trimethylamine can produce a wide range of odors. Do you think trimethylamine could cause the wide range of gut smells on its own
Answer:
No. However it can be a component in complex mixtures of products that are responsible for the varying odors among individuals.
It is for this reason that the National Institutes of Health recommends an odor-reducing management protocol for TMAU in their websites,
Genetests.org page on Trimethylaminuria
Rarediseases.info.nih.gov: What treatment is available for trimethylaminuria?
which in addition to a low choline diet and vitamin supplements, they also recommend the following:
Sequestering of trimethylamine produced in the gut:Cass goes on to say in her interview that,
• Activated Charcoal: 750mg twice daily for 10 days
• Copper Chlorophyllin: 60mg three times/day after meals for 3 weeks
Suppression of intestinal production of trimethylamine: A short course of antibiotics to modulate or reduce the activity of gut microflora, and thus suppress the production of trimethylamine.
There is a 'diagnosis' of 'Secondary TMAU', where the enzyme involved is deemed fine, but the person has too much trimethylamine. Do you have any suggestion as to how to kill off the TMA-producing bacteria in particular?
Answer:
The first thing to do is lower protein intake and improve protein digestion to reduce undigested nitrogenous substrates (amino acids) that must be present to form ammonia. Perhaps water or juice fasting could be beneficial in these instances as it can change the microbial content of the gut. If you don’t feed the colonic bacteria, they can’t grow and produce strange products.
Some feel that trimethylamine can produce a wide range of odors. Do you think trimethylamine could cause the wide range of gut smells on its own?
Answer:
No. However it can be a component in complex mixtures of products that are responsible for the varying odors among individuals.
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