Trimethylamine also known as Trimethylaminuria and Fish Malodour Syndrome – is a rare genetic metabolic disorder. The sufferer gives off a strong, offensive fish-like odor that cannot be washed away through increased hygiene considerations. This condition is rarely identified during childhood and has occasionally developed after a patient has suffered kidney or liver disease. It is also more likely to be developed by a female patient. The disorder is usually released through sweat, breath and urine and can be triggered by stress and poor diet.
Trimethylamine is caused by defects in an enzyme that breaks down the bacteria that lives in the gut. Tiimethylamine, is a byproduct of protein digestion and it is this compound that has the unpleasant odor of garbage or fish.
Types of Trimethylamine
There are several types of fish malodour syndrome. The best understood is Primary Genetic Form, which concerns the family of enzymes known as flavin monooxygenase. Acquired Form is diagnosed when there is no childhood or family history, of the syndrome, but there is evidence of hepatitis. Transient Childhood Form and Transient Form Associated with Menstruation deal with more specific focus. The remaining type is referred to as Precursor Overload and this focuses entirely on dietary influence.
Diagnosis of Trimethylamine
Ttrimethylaminuria can be inherited in an autosomal recessive pattern, which means that gene cells are altered. If the condition is known to occur within a family genetic testing can be used to identify the trimethylamine carrier. This is done by analysing blood tests and measuring urine samples. If a carrier is identified the individual may be given a high dose of choline in order to make further tests.
The correct diagnosis of the fish malodour syndrome will help a sufferer understand the best course of potential assistance treatment. Being aware that specific influences, like menstruation, stress and poor diet can increase or decrease strong odor may help a sufferer manage the condition in a way that has positive effect on their lifestyle and personal life.
Coping with Trimethylamine
There is currently no cure for trimethylamine so sufferers must manage the condition in the best way they can. Some sufferers may experience fluctuations in the strength of the unpleasant odor, although some people may also release this strong smell all of the time. Because the compound is released inside of the body increased washing, and masking of the smell with perfumes, makes no impact on the odor. Finding a way to manage the stress caused by living with this condition should therefore be of primary concern.
Low doses of antibiotics may temporarily help kill off the bacteria in the gut and lessen the odor. Making changes in diet will also help control the amount of bacteria in the stomach and it has been reported that limiting certain food additives, like lecithin which is naturally found in eggs, corn and soybeans, may also be productive in reducing strong odor. Following a low protein diet will also restrict the amount of amino acid choline that builds up inside the body. This acid is present in meat, fish, eggs and beans.
There is no known treatment for trimethylamine. Making changes in diet however, may help to reduce strong odors and help in the management of symptoms. The fishy odor may be reduced by limiting consumption of foods like red meat, fish, beans, as well as other foods that contain choline, sulfur, nitrogen and lecithin. Avoiding egg yolks and legumes may also help.
In some cases taking a low dose of antibiotics can help to reduce the amount of bacteria that is present in the gut. Supplements that contain activated charcoal and copper chlorophyllin may help the body oxidize the bacteria reduction and therefore reduce the fishy odor.
Washing and bathing with products that have an increased acidic detergent, with a pH of 5.5-6.5 may also have a positive effect on reducing strong tainted odor.
Support and Understanding
Counselling and stress management may help a sufferer deal with the managing of their symptoms and the way in which they react to the negative understanding of others. Children, suffering from trimethylamine, in particular may find it difficult to cope with peer rejection and will benefit from being able to understand how to overcome the emotions that arise as a direct result. The objectionable fish odor may impact on the personal, social and work life of individuals suffering from trimethylaminuria because little is known about the condition and therefore it is usually dismissed as a hygiene problem, which is not the case.