Subclinic tmau

[aydinmur]

Halitosis is not genetic. But some familial diseases cause body odor and halitosis.

If someone suffers from familial body + oral bad odor, he should check for subclinic tmau (trimethyl aminuri) disease.

I give you an easy way to understand subclinic tmau disease if any.

Provide choline tablet from here: http://www.gnc.com/product/index.jsp?productId=2133450

First day 1 tablet - check bad odor every day
Second day 2 tablets -
Third day 3 tablets -
Stop taking Choline.

If bad odor enhances each of three days, then think tmau.

-M

[halitosisux]

Aydinmur, it's always good to know you are around.

Have any of your patients ever turned out to have TMAU? If so, are their bad breath symptoms and experiences much different to those of your patients who do not have TMAU?

[mike987]

If one doesn't have TMAU, will Choline have any effect on the breath?

[halitosisux]

I've read somewhere that if you eat enough eggs you will smell like someone who has TMAU. This is whether you have TMAU or not, because the body can only deal with so much trimethylamine.

Mike, I think it totally depends on how much choline you take. There will always be a point where even a non-TMAU person will smell if they have too much choline.

But, going by what Aydinmur has proposed there, if your smell enhances after the third day taking 3 tablets, then think TMAU.

[aydinmur]

Have any of your patients ever turned out to have TMAU? If so, are their bad breath symptoms and experiences much different to those of your patients who do not have TMAU?

Halitosisux, You ask always correct questions.
Such cases have some common clinic signs

- They are usually female.
- They usually have body odor plus halitosis.
- Metronidazol ceases bad odor
- There is not always bad odor, some times bad odor spontaneously disappeared for hours.
- Physical movements neither stop nor decrease bad odor.
- Sulphur gases decrease in their mouth.
- May or may not have at least one family member who have bad odor.
- more signs in blood profile.

If one doesn't have TMAU, will Choline have any effect on the breath?

Depends on dose. Its break point appears nearby 600 mg/day for healthly adults. Over dose cholin may cause bad odor in urine, then, sweat, vagina, breath for approximately 8 hours or so.

-M

[MissPretty]

My whole family has bad breath. How can this be?

[halitosisux]

Thankyou for the reply Aydinmur, lots of food for thought there.

Could you please elaborate on what you mean when you say that sulphur gases decrease in the mouth. Do you mean that people with TMAU generally have reduced sulphur gases in their mouth?

Also, what signs in blood profile?

Also, the fact that Metronidazole ceases bad TMAU odour, true also in most type-1 cases because of the effect of metronidazole on the oral microbial flora, could this indicate that where metronidazole has no effect on odour, that the bad breath is less to do with microbial flora in those cases and more to do with chronic infection somewhere in the body that the metronidazole cannot even make a dent on - such as the sinuses?

[halitosisux]

I've said it a number of times over the last year that it would be a good experiment to try choline tablets to see whether it exacerbates your odours. Likewise, if it does exacerbate it, to try a diet that is low on choline to see what effect that has.

@misspretty, apart from the fact that BB is fairly common anyway and your family may just be a statistical cluster, within a family there might be inherited traits that predispose the entire family to more susceptibility to the kind of problems that can lead to bad breath.

There may also be more to it than that.

[aydinmur]

Do you mean that people with TMAU generally have reduced sulphur gases in their mouth?

Yes.
They smell methylated amines but not sulfur. They have lesser sulfur gases in their mouth. Its reason not clear. In a study (Whittle CL, 2007), oral sulfur gases compared between Tmau people and healthly subjects.

COS 0.416 - 1.08 (ng/10ml)
H2S 0.83 - 2.17
CH3SH 0-1.97
(CH3)2S 0 - 0.21 (tmau and control respectively)

Also, the fact that Metronidazole ceases bad TMAU odour, true also in most type-1 cases because of the effect of metronidazole on the oral microbial flora, could this indicate that where metronidazole has no effect on odour, that the bad breath is less to do with microbial flora in those cases and more to do with chronic infection somewhere in the body that the metronidazole cannot even make a dent on - such as the sinuses?

You use long sentences, I can not fully understand your question. Here metronidazol decreases bacterial load in gut. Also, in order to decrease bacterial load, lactulose and neomicin can be used instead of metronidazol. I dont know how they work.
-M

[caramiamine98]

It’s important to note that it is possible to have TMAU and have BB and no body odour. There are different types of TMAU. Primary TMAU (TMAU1) is genetic and the result of a faulty autosomal recessive gene and Secondary TMAU (TMAU2) the acquired type is due to having too much intestinal trimethylamine (TMA) due to an overgrowth of TMA-generating bacteria.

TMAU1 and TMAU2 possible sub-types:

a. TMAU1 transient neonatal – possible delay in switch from fetal enzyme
FMO2 to FMO3 TMA oxidation, but resolves during development.
b. TMAU1 severe childhood - parenting / schooling problems are possible.
c. TMAU1 adulthood – probably presented in childhood; long-term sociopathy.
d. TMAU1 heterozygote – may present only during dietary load / menses.
e. TMAU1 very mild – ‘double dose’ DNA polymorphisms – TMA borderline.
f. TMAU1 FMO3 mutation proven TMAU1 with increased TMO (like TMAU2)

a. TMAU2 severe neonatal -‘sepsis’ massive TMA responds to antibiotics.
b. TMAU2 childhood - antibiotic eradication prevents school / social problems.
c. TMAU2 adulthood – may have long history of odour, eradication possible.
d. TMAU2 intermittent – difficult diagnosis without precursor load.
e. TMAU2 due to UTI – presents biochemically as TMAU1 (urine-only odour).
f. TMAU2 due to renal or hepatic dysfunction – presents as TMAU1.

http://www.bloodbornebodyodorandhalitos ... -from.html

[halitosisux]

That's really interesting. Could that be due to some kind of chemical reaction taking place in the mouth with secreted trimethylamine contained in the saliva and the sulphurous compounds?

Perhaps a better way to describe what I meant about the metronidazole is that if a person with bad breath does not notice any difference when they take metronidazole, would that mean that TMAU could be ruled out in those cases?

Where metronidazole does not make any difference to a person's bad breath, does that give any clues to you?

[Larc400]

Yes.
They smell methylated amines but not sulfur. They have lesser sulfur gases in their mouth. Its reason not clear. In a study (Whittle CL, 2007), oral sulfur gases compared between Tmau people and healthly subjects.

COS 0.416 - 1.08 (ng/10ml)
H2S 0.83 - 2.17
CH3SH 0-1.97
(CH3)2S 0 - 0.21 (tmau and control respectively)

Will a machine like the OralChroma detect bad breath caused by TMAU?

http://www.fisinc.co.jp/en/products/oralchroma.html

[potty_mouth]

Will a machine like the OralChroma detect bad breath caused by TMAU?

http://www.fisinc.co.jp/en/products/oralchroma.html

No, unfortunately it won't.

The Mebo research test being conducted with Menssana should show up these gases. I think they will be conducting tests in London, which is probably the nearest to you.

viewtopic.php?t=4046&postdays=0&postorder=asc&start=0

[halitosisux]

Potty_mouth, I can't remember if I've asked you this already, but can a GC be used to measure the amount of TMA in a breath sample?

If it can, then can a GC be used to diagnose whether a form of TMAU is responsible for a person's breath odour?

[potty_mouth]

Potty_mouth, I can't remember if I've asked you this already, but can a GC be used to measure the amount of TMA in a breath sample?

If it can, then can a GC be used to diagnose whether a form of TMAU is responsible for a person's breath odour?

Yes, these guys appear to have done it:
http://iopscience.iop.org/1752-7163/4/2 ... D533556.c3
I'd have to do a bit more reading to see what kind of levels of TMA are blown by TMAU patients, as I doubt that there is an official threshold which would diagnose TMAU. You would also have to check levels of other gases to be sure they weren't significant, but that can be done with the GC too.