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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Trimethylaminuria


Other Names for this Disease
  • Fish malodor syndrome
  • Fish odor syndrome
  • Stale fish syndrome
  • TMAU
  • TMAuria
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Treatment

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How might trimethylaminuria be treated?

Although there is no cure for trimethylaminuria, the following are some ways to reduce symptoms of odor:[1][2]
  • Avoidance of foods that contain trimethylamine and its precursors (choline, lecithin, and trimethylamine N-oxide). Trimethylamine is present in high levels in milk obtained from wheat-fed cows. Choline is present in high amounts in: eggs, liver, kidney, peas, beans, peanuts, soy products, brussels sprouts, broccoli, cabbage, and cauliflower. Trimethylamine N-oxide is present in seafood   
  • Low doses of antibiotics. This decreases the amount of trimethylamine that is made by bacteria in the intestines   
  • Laxatives can decrease the amount of time food remains in the intestines and reduce the amount of trimethylamine made   
  • Nutritional supplements (activated charcoal and copper chlorophyllin) can decrease the concentration of trimethylamine in the urine
  • Soaps with a moderate pH (between 5.5 and 6.5) can help remove the secreted trimethylamine   
  • Riboflavin (vitamin B2) supplements can enhance any existing FMO3 enzyme activity (which breaks down trimethylamine)   
  • Avoidance of exercise, stress, emotional upsets, and other factors that can promote sweating
People with trimethylaminuria may also find the following to be helpful:[1]
  • Behavioral counseling to help with depression and other psychological symptoms
  • Genetic counseling to better understand how they developed trimethylaminuria and the risks of passing the condition on to their children

NOTE
: People should follow the treatment advice of their healthcare provider and should not attempt to self-administer these treatment approaches. Medications and supplements can have unintended interactions, and dietary restrictions can result in nutritional deficits.
Last updated: 3/26/2015

References
  1. Learning about Trimethylaminuria. National Human Genome Research Institute. July 2011; http://www.genome.gov/11508983.
  2. Phillips I, Shephard E. Trimethylaminuria. GeneReviews. April 19, 2011; http://www.ncbi.nlm.nih.gov/books/NBK1103/.


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Management Guidelines

  • GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Click on the link to view the article on this topic.

Clinical Trials & Research for this Disease

  • The U.S. National Institutes of Health, through the National Library of Medicine, developed ClinicalTrials.gov to provide patients, family members, and members of the public with current information on clinical research studies. There is a study titled Studies of Children with Metabolic or Other Genetic Disorders¬†which may be of interest to you. To find this trial, click on the link above.
Other Names for this Disease
  • Fish malodor syndrome
  • Fish odor syndrome
  • Stale fish syndrome
  • TMAU
  • TMAuria
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.