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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

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UK residents survey : Prof Shephard/MEBO (until 31/1/21) click to visit survey
click to Read more/less

Prof Elizabeth Shephard is conducting a TMAU fact-finding survey for UK RESIDENTS. She plans to use it to raise awareness with decision-makers, such as perhaps MPs. It closes 31 Jan 21.

who is the survey intended for ?
UK residents who identify with TMAU

Living with TMAU study

We invite you to participate in a research project entitled ‘Living with TMAU’.

click to visit survey

survey full url :

Participation in the project will involve completion of a short questionnaire, which aims to capture the experiences of those living with the condition. There are two questionnaires.

For individuals with TMAU over the age of 18

For a parent or guardian of a child with TMAU.

The results from the questionnaires will be compiled to produce a report that will be available for you to use, for example, to lobby your MP. The findings will be used to reach out to policy makers in the UK to have TMAU recognised as an invisible disability and to make people aware of what it is like to live with the disorder. The report will be made available on the MEBO, UK website.

To complete either questionnaire you must be over 18 and resident in the UK. The questionnaire responses are anonymous and no personal identifiers will be collected.

The questionnaire closes 11:59 pm (GMT) Sunday 31st January 2021.

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, July 5, 2020

Primary & Secondary Secondary TMAU, updates on treatment & research 2020

Click on icon
for full paper

"Treatments of trimethylaminuria: where we are and where we might be heading", Aaron C. Schmidt and Jean-Christophe Leroux, of the Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, Zurich, Switzerland,

  • Presents a good description of Primary and Secondary TMAU,
  • Discussion on the pros and cons of TMAU treatment options and ongoing research directly or indirectly related to TMAU,
  • Discussion on ongoing research directly and indirectly related to TMAU.

Definition of Secondary TMAU:

Secondary TMAU
Often referred to as acquired or sometimes transient TMAU, people becoming afflicted with secondary TMAU might show prolonged symptoms. This form of the disorder can occur in a variety of different scenarios. Treatment with choline in Huntington’s and Alzheimer’s diseases has been associated with the development of a strong fishy body odor [26,27], and is a classic example of precursor overload where the enzyme is unable to completely oxidize the TMA burden. Liver failure and portosystemic shunting of the blood can also result in increased TMA levels, owing to interference with first-pass metabolism [28,29]. Other factors that have been reported to cause or exacerbate the condition (including primary TMAU) encompass menstruation [30,31], asymptomatic viral hepatitis [32] and testosterone treatment [33], and have been reviewed elsewhere [4].
Treatments of trimethylaminuria: where we are and where we might be heading

Treatment options discussed:

  1. Limiting precursor intake
  2. Protonation of TMA
  3. Targeting gut metabolism
  4. Antibiotics
  5. Probiotics, including Methanogenic archaebiotics, Fecal microbial Transplantation (FMT).

Some ongoing research studies:

Fecal Microbial Transplantation

In the Fecal microbial transplantation (FMT) discussion, the authors present findings reported by Dr. Stanley Hazen, MD, et al. while studying FMT in the context of CVD [105]. Since Dr. Hazen's focus is on on the results of TMAO levels in the blood, as opposed to TMA levels, even though TMAO levels in serum leveled out after 16-20 weeks of FMT, it does not necessarily translate into reduction in TMA. Therefore, further research with TMA being the focus, as opposed to TMAO, is needed.
Gregory, J.C. et al. (2015) Transmission of atherosclerosis susceptibility with gut microbial transplantation. J. Biol. Chem. 20, 5647-5660

 DMB and Aspirin

Dr. Hazen's research on DMB and aspirin (2012, 2013, 2015):

In 2012, Hazen et al. patented the small molecule 3,3-dimethyl-1-butanol (DMB) and similar compounds for their ability to lower intestinal TMA in the treatment of CVD [108]. After observing decreased TMA production from choline in mouse cecum in vitro, DMB was administered to C57BL/6J mice in drinking water, resulting in a reduction of urinary and plasma TMA levels. The proposed mechanism of action was the inhibition of several TMA lyases, including choline TMA lyase, as determined in vitro [109]. The patent was further extended to acetylsalicylic acid (ASA) and its derivatives, because ASA showed inhibition of TMA lyase activity of Proteus mirabilis – a microbe with abundant TMA lyase activity in an in vitro setup [110].

[108] Hazen, S.L. et al. (2013) Treatment and prevention of cardiovascular disease and thrombosis. US9168233B2.
Google Scholar

[109] Z. Wang, et al.
Non-lethal inhibition of gut microbial trimethylamine production for the treatment of atherosclerosis
Cell, 163 (2015), pp. 1585-1595
Download PDF

[110] Hazen, S.L. (2015) Treating and preventing disease with tma and tmao lowering agents US20160089386A1.
Google Scholar



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Anonymous said...

Would combining resveratrol and aspirin have a similar effect? I'm going to try it right away!

Jul 7, 2020, 2:41:00 AM
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