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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

Full details :
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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

MEBO Private Facebook Group
to join : go to
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Join/Watch the weekly
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)

Sunday, August 30, 2009

About the leaky gut test (intestinal permeability test)

Intestinal permeability lactulose/mannitol urine test

lactulose : big molecule : not absorbed (much)

mannitol : small molecule : absorbed
There is some interest in the 'intestinal permeability' ("leaky gut") urine test in connection to fecal body odor syndrome. It is hoped this post explains the test to some degree. It is not known if 'leaky gut' is a factor at all in fecal body odor, or if it is typical but not an issue. At this stage of understanding fecal body odor, like many things it is an unknown factor. However, it cannot be good to have 'leaky gut' at all.

Originally the 'leaky gut' test was one of the tests chosen for the MeBO-Biolab gut dysbiosis study, but was dropped to keep the price under £100. However, since the volunteers are paying for their own tests, it was thought sensible to add it as an option. The Biolab 'leaky gut' test uses a different molecule from other testers of 'leaky gut', who normally use lactulose and mannitol as the test molecules. However they all have the same principle.

Someone recently did the lactulose/mannitol intestinal permeability test, and we will look at their results to explain the test. Although people think of the test as the 'leaky gut' test, it does in fact test both for leaky gut and how well mannitol is absorbed as well. This is why it is officially known as the 'intestinal permeability' test.

The 2 test molecules for most 'intestinal permeability' tests are lactulose and mannitol. Lactulose is a large sugar, and should not be absorbed (much) in a normal gut. Mannitol is a small sugar, and should be absorbed in a controlled manner. Neither are changed by the body (i.e. metabolized). The person takes a liquid with both sugars and then over the course of a few hours collects their urine.

Leaky gut : normally the gut lining acts as a filter, allowing only molecules of a certain size to be absorbed into the bloodstream. Molecules of a larger size should not get through (unless they are broken down further in the intestine to smaller molecules). The theory about leaky gut is, the cells lining the intestine normally have a tight junction between them, and if for any reason this junction becomes split, then large molecules can slip into the bloodstream through the gap. These molecules will be regarded as 'aliens' by the body, and may trigger immune responses. The body will not recognise them as normal. In most 'leaky gut' tests, lactulose is used as the test molecule, and a raised amount in the urine constitutes 'leaky gut'.

Mannitol absorption : Normally molecules small enough to be absorbed into the bloodstream are absorbed through the gut lining in various ways. Some by simple diffusion. Many by a complex 'active transport' system. They go through the cell lining directly (not the juction). Mannitol should be relatively well absorbed, in a controlled manner. If absorption is too low, then there is an issue with mannitol absorption (and so probably with most type of gut absorption). If it is too high, it implies some issue in the controlled method of absorption.

Now to look at the test results of someone :

Intestinal permeability lactulose/mannitol urine test results:
intestinal permeability
lactulose recovery 2.37 *H (normal range less than 0.30)
mannitol recovery 69.2 *H (normal range 9.5-25.0)
lactulose:mannitol ratio 0.034 (normal range less than 0.035)
6 hour urine volume 1.700 litres
In this case, both the lactulose and mannitol absorption are too high. Both by quite a bit. Ironically, this makes the 'ratio' almost normal, but this is because both are so high. So there seems to be leaky gut for sure, and also possibly an absorption issue. More about the lactulose/mannitol intestinal permeability test can be seen in these links from Genova Diagnostic website:

Genova intestinal permeability test explanation (PDF document)
Genova intestineal permeability test sample report (PDF document)

So, in summary, it is not known if intestinal permeability is a factor in fecal body odor syndrome, but at this early stage of understanding the problem, it may be worth ruling out as a potential factor.

The Biolab intestinal permeability test is one of the test options in the MeBO-Biolab gut dysbiosis study.

More about leaky gut :
'About Medicine' article on intestinal permeability test by Liz Lipski
Genova Diagnostic intestinal permeability test through for $90
Leaky gut syndrome : Leo Galland 1995 article
1999 Pubmed paper : Leaky gut in alcoholic cirrhosis: a possible mechanism for alcohol-induced liver damage


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