Can TMAU worsen with age?

Dr Dolphin was part of the team who first demonstrated that mutations in the FMO3 gene are the cause of the inherited (primary form) of TMAU.

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Can TMAU worsen with age?

Postby trtr654 » Tue Dec 02, 2014 4:03 pm

Dear Dr Dolphin:
Firstly thank you very much for reading this message. This may seem like a nuisance to you but it means a lot to me. Recently I've been struck in a cycle of fear and depression.

I'm a 17 year old boy that's normally healthy. There was one day this year where I've eaten a piece of shark meat (that is high in TMAO)and they next day I smelled badly of fish according to people. I thought it may be a one off thing and it didn't happen for another month even with high meat diet. Today though, the fish smell seems to come back and my friends said it's only very very vague if smelled my palms up close. I have eaten a lot of lamb and fish balls the night before. Also for both days I had little sleep (6hrs). I also tried eating cod and chips once but didn't smell.

Either way it's undeniable I have reduced FMO3 activity. So here are my questions:

1.Can normal people smell a bit like fish after eating lots of it? because normal people have 90%TMA converted but 10% not.

2.will my symptoms worsen as I age? Or can I cope with living a low choline life?

3.Would I have primary TMAU or Secondary TMAU at this age?

4.If primary, am I a homozygous or heterozygous?

5. Is it necessary to do the TMA load test before genetic testing? Because it's probably going to be positive and I feel genetic testing would give a better confirmation on whether I'm primary or secondary.

May I beg you please reply patiently to my questions, you are the only person that can stop me having panic attacks everyday, and thank you very much.

Jing Qiu
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Joined: Fri Oct 17, 2014 10:59 pm

Re: Can TMAU worsen with age?

Postby FADworker » Thu Mar 26, 2015 10:06 pm

Dear Jing

Firstly, apologies for the delay in answering your question. Shark does indeed contain high amounts of TMAO. Sharks, and many other elasmobranchs, use TMAO as an 'osmolyte' - a molecule that is chemically inert and, with respect to its ionic charge, innocuous in that it does not influence or interfere with the normal function of the cell. As such, TMAO is present in high concentrations in the shark's cells and acts to balance the osmotic difference between the cells of the shark and the surrounding sea water which is high in salt. If you ate lots of shark flesh, and thus ingested significant amounts of TMAO, you might just have saturated your FMO3 activity and thus have had a transient breakthrough of TMA and hence odour. Unless you get tested for known FMO3 inactivating mutations it is difficult to say whether this was due to any underlying defect in one or both copies of your FMO3 gene or just a 'saturation' event that may not occur again.

With rspect to ageing and TAMU - I would suggest that at 17 you have many years ahead of you and that a transient TMAU episode should not be of too much concen. If you experience more TMAuric events then try and get tested for TMAU. If you discover you have FMO3 insufficiency - whether due to inactivating mutations in FMO3 or possible GI bacterial 'overgrowth' - then you can start to control your diet to minimize your dietary intake of TMA precursors.

At the moment it doesn't sound as though you have too much to worry about.
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Re: Can TMAU worsen with age?

Postby trtr654 » Sun Apr 12, 2015 12:48 am

Many thanks Dr Dolphin.
I've tried an NHS urine test and the sample seems to got lost somewhere :lol: Then I did a 23andme gene test and for the few codons they tests for, I'm heterozygous for impaired FMO3 activity. I guess I'll stick with a non seafood diet for the rest of my life, goodbye fish :mrgreen:

Again thank you very much Dr Dolpin for the time you spent, you certainly cured my anxiety.
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Joined: Fri Oct 17, 2014 10:59 pm

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