FISH ODOR SYNDROME (Trimethylaminuria)

A disorder in which the body is not able to break down trimethylamine, a compound coming from the diet that has a strong odor of rotting fish.

  • Trimethylamine build up causes people with the condition to have their urine, breath and sweat smelling like a fish, with changing intensity over time. This pungent smell may cause problems in daily life, disturbing a person’s career, relationship or social life.
  • Causes of the condition are as follows:
    • Gene mutation
    • Too much of certain proteins in diet
    • Increase in bacteria that produces trimethylamine in the digestive tract
    • Liver or kidney disease (few cases)
    • Prematurity
    • Beginning menstruation

DIAGNOSIS

  • Physician may do/request:
    • History & Physical Exam
    • Urinalysis
      • For trimethylamine to trimethylamine oxide ratio
    • Blood test

 

RECOMMENDED MEDICATIONS

  • Cure unknown
    • Symptomatic management and counseling may help
  • Possible ways to decrease smell
    • Avoiding foods such as red meat, beans, egg yolks
    • Antibiotics (as prescribed by doctor)
    • Using slightly acidic detergent (pH between 5.5-6.5)

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