Trimethylaminuria And That Fishy Odor Syndrome
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Trimethylaminuria and that Fishy Odor Syndrome

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Halitosis or bad breath can create embarrassing social situations for some people. Bad breath usually originates in the oral cavity, but in rare instances it can be a systemic problem. One such systemic cause is a genetic disease named trimethylaminuria, which is a metabolic disorder of the gastrointestinal tract. Here's what you need to know about the disorder and how it affects your oral heath.


If you have this disorder, it means you have an inherited enzyme deficiency. During digestion, trimethylamine is produced in the stomach from the precursors of trimethylamine-N-oxide and choline. It has a fishy odour, but is normally converted back into trimethylamine oxide in the liver by the actions of an enzyme, and this by-product is typically odourless.

If you lack that enzyme, however, there is an accumulation of trimethylamine, which is eventually excreted in the urine. Although much of the trimethylamine builds up in the urine, it can also be released in sweat and the breath, causing a distinctive fishy odour. The combination of this bad breath and body odour can diminish your self-confidence.

Trimethylaminuria Diagnosis and Treatment

In order to make a diagnosis, your physician must rule out other disorders that may be causing uncontrollable body odour. In a suspected case of trimethylaminuria, a urine sample is analysed to determine the trimethylamine and trimethylamine-N-oxide levels.

Trimethylaminuria symptoms are managed through dietary adjustments, such as avoiding fish and other foods high in trimethylamine-N-oxide. Sometimes antibiotics are prescribed to attempt to correct your stomach's flora (or germs). Activated charcoal can also be used to try to bind the trimethylamine in the stomach.

Effects on Your Oral Health

While there is no known or documented negative effect of trimethylaminuria on the teeth or gums, it is a potential cause of bad breath. The tongue is the area most likely to host the germs that cause bad breath, so a toothbrush with a built-in tongue scraper can help scrub away these germs. In the end, however, don't forget that this is a medical problem that requires intervention from your dentist and physician. To keep bad breath at bay, no matter its origin, good oral hygiene goes a long way. Consider a daily routine of mouthwash and toothpaste, and invest in a quality toothbrush to freshen your breath and restore your confidence.

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