What other kinds of TMAU are there?

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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What other kinds of TMAU are there?

Postby crazyinCA » Tue Jul 05, 2011 8:59 pm

Hi Dr. Dolphin,

Nice to have a doctor here to answer our questions who is familiar with TMAU! If you can't answer my question know that it is okay... but I figured I would ask anyways.

I had a urine test for TMAU last summer. I did the choline load test. The results came back positive. I then saw a geneticist who had me do a blood test. The results came back that I did not have a mutated FMO3 gene. I am guessing this means I do NOT have primary TMAU, but I really don't know. What other kinds of TMAU are there? What else could be to blame for this nasty disorder?

I thought maybe my hormones were playing a huge role in my symptoms because the doctor's told me a few years ago that I was pre-menopausal. My symptoms were a thousand times worse before, during, and shortly after my period so I started taking birth control pills to limit the number of cycles I had during the year. That's when the symptoms became daily! My doctor then put me on shots of lupron (?) to stop my cycles completely. It helped a little bit so I then had a hysterectomy. I was really hoping once I had all of THAT removed that my symptoms would lessen but they haven't. I have seen a metabolic dietitian but she just gave me a list of foods and their choline count. I was told to avoid eggs for sure. It's been a year now and I have only figured out that fried food, garlic, and onion are problematic... but I still have symptoms nearly daily and I can't figure out what other foods could be causing problems.

Any advice or insight would be greatly appreciated.

Thank you!
crazyinCA
 
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Re: What other kinds of TMAU are there?

Postby FADworker » Fri Jul 08, 2011 10:11 pm

crazyinCA wrote:Hi Dr. Dolphin,

Nice to have a doctor here to answer our questions who is familiar with TMAU! If you can't answer my question know that it is okay... but I figured I would ask anyways.

I had a urine test for TMAU last summer. I did the choline load test. The results came back positive. I then saw a geneticist who had me do a blood test. The results came back that I did not have a mutated FMO3 gene. I am guessing this means I do NOT have primary TMAU, but I really don't know. What other kinds of TMAU are there? What else could be to blame for this nasty disorder?

I thought maybe my hormones were playing a huge role in my symptoms because the doctor's told me a few years ago that I was pre-menopausal. My symptoms were a thousand times worse before, during, and shortly after my period so I started taking birth control pills to limit the number of cycles I had during the year. That's when the symptoms became daily! My doctor then put me on shots of lupron (?) to stop my cycles completely. It helped a little bit so I then had a hysterectomy. I was really hoping once I had all of THAT removed that my symptoms would lessen but they haven't. I have seen a metabolic dietitian but she just gave me a list of foods and their choline count. I was told to avoid eggs for sure. It's been a year now and I have only figured out that fried food, garlic, and onion are problematic... but I still have symptoms nearly daily and I can't figure out what other foods could be causing problems.

Any advice or insight would be greatly appreciated.

Thank you!


At the moment I believe that only those mutations which have been described in the scientific press would be tested for. Since the first description of FMO3 gene mutations in 1998 approximately 20 or so have been found. Of course, there is always the unlikely possibility that you have a mutation that hasn't be discovered yet and so can't be tested for but I would think this is very unlikely.

People with non-genetic TMAU (TMAU2) are likely to have active FMO3 enzyme in the liver but just not enough of it. There could be many reasons for this drop in FMO3. Unfortunately, and rather unusually for enzymes like FMO3, there is no other enzyme in the liver that can convert the TMA (smelly) into the TMA oxide (non-smelly) and so without FMO3 the TMA will be excreted and result in the fishy body odour. There are actually five FMO enzymes FMOs1-5 but only the FMO3 can convert TMA to TMAO.

Finally, the level of FMO3 has been shown to drop during menstruation that might lead to low levels of TMA release. Some scientists have even suggested that this is a very ancient 'signal' to a male that this would be an inappropriate (wasteful) time to attempt to mate.
FADworker
 
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