You may be familiar with the popular American television show Breaking Bad.In the show, the lead characters make the drug methamphetamine from phenylacetone and methylamine, an analogue of trimethylamine where two of the methyl groups are replaced by hydrogens.As methylamine is a controlled chemical in the US, several episodes revolved entirely around obtaining the hard-to-get reagent. Given what we know about how toxic TMAO can be, cutting down on animal products may not just save the, lives of people with a rare genetic disorder, but it could help save everyone elses, Indeed, rather than trying to genetically engineer a bacterium that. Quantitative Analysis HPLC. Since this condition usually requires two altered genes to cause symptoms, typically neither parent of an individual with trimethylaminuria has any symptoms. all deplete stomach acid and change the gut flora. Yes, proton pump inhibitors (Prilosec, omeprazole, Prevacid, Nexium, etc.) While the amount of fat required to boost TMAO isnt clear, one study has pegged the value at 55% of your calories coming from fat. Biochem Pharmacol. Indeed, rather than trying to genetically engineer a bacterium that eats up trimethylamine or ingesting a gut enzyme from cows and sheep to convert it into methane, simply limiting the consumption of foods rich in choline and carnitine, perhaps specifically L-carnitine, may effectively limit the amount of TMAO circulating in our body. There are a number of genetic variants affecting the activity of . The TMA just doesnt get oxidized into TMAO. Ive always been told that carnitine is good for the heart. It turns out that Brussels sprouts appear to downregulate that TMAO liver enzyme naturallynot enough to make you stinky, but just enough to drop TMAO. High saturated fat levels in red meat have long been known to contribute to heart disease, the leading cause of death in the United States. Weve known about the troublesome transformation from choline into trimethylamine (TMA) for more than 40 years, but that was long before we learned about its connection to heart disease. How Does Trimethylamine Increase Cardiovascular Risk? Monell Chemical Senses Center He has over 16 years of medical training and facilitation and is a Diplomate of the American Board of Internal Medicine. J Clin Invest. Should we be concerned about high-choline plant foods, such as broccoli, producing the same toxic TMAO that results from eating high-choline animal foods, such as eggs? That doesnt work. Indeed, studies show that people who dont eat meat, dairy, or eggs can virtually eliminate TMAO from their blood. You can give a vegan a steak, which contains choline and carnitine, and not even a bump in TMAO, since vegetarians and vegans have different gut microbial communities. Am J Med. So, it really is a measure of which factor is more dominant or which factor outweighs the other. This website does not create a doctor-patient relationship between you and Dr. John Day. Gene testing called gene sequencing can be used to look for mutations in the FMO3 gene. Maintain a lean healthy weight. Please considervolunteeringto help out on the site. May be incompatible with isocyanates, halogenated organics, peroxides, phenols (acidic), epoxides, anhydrides, and acid halides. Gaci N, Borrel G, Tottey W, O'Toole PW, Brugre JF. This article has been viewed 58,012 times. However, they accept samples from people in the United States. The following are some ways a person with trimethylaminuria can lower symptoms of odor: Avoiding foods containing trimethylamine and its precursors (choline, lecithin and trimethylamine N-oxide). Taking low doses of antibiotics to reduce the amount of bacteria in the gut. If you have a medical problem, immediately contact your healthcare provider. 2004. People on blood thinners however are advised not to take baby aspirin for the most part. You have to call the number for the company then arrange for a local blood draw and then mail your sample, Dear Dr John Day And the more I read about TMAO, the more I am convinced that I dont want this potentially toxic byproduct in my bloodstream. Free water-soluble uremic toxins like trimethylamine N-oxide (TMAO) aggravate renal dysfunction in CKD patients and enhance the chance of CVD [58], [59], [60]. Do we need to, about high-choline plant foods, like broccoli? Activated charcoal taken at a dose of 750mg twice daily for ten days. However, like countless other biomarkers of health, this isnt a blood test your doctor will probably be able to do for you. Dietary modification of the microbiome affects risk for cardiovascular disease. TMAO may be a key dietary component of an unhealthy diet that contributes to disease promotion. People who eat completely plant-based may not make any TMAO at alleven if they try. Both parents of an individual with trimethylaminuria are "carriers" of the condition, in other words, they both carry one copy of an altered gene for FMO3. 2015 Sep;242(1):141-4. Smelling like dead fish: a case of trimethylaminuria in an adolescent. As methylamine has the least number of alkyl groups, the inductive effect by the alkyl group is the least out of methylamine, dimethylamine, and trimethylamine. By minimizing the consumption of full-fat dairy products (including whole milk, egg yolk, cream cheese, and butter); both processed and unprocessed red meat (beef, pork, lamb, and veal), as well as nutritional supplements and energy drinks containing choline, phosphatidylcholine, and/or L-carnitine. The following laboratories are able to assist in the diagnostic testing of patients who may have trimethylaminuria. There has been mixed success at reducing TMAU symptoms by taking vitamin B2, zinc, kelp pills, or copper chlorophyllin. However, it may be possible to reduce the bad odor by taking different steps. Researchers at the Cleveland Clinic screened blood from patients who had either had a heart attack or a stroke and compared the results with those from the blood of people who had not experienced either. However, excess choline, such as that found in eggs, may be worth avoiding.. Trimethylamine (TMA) is a chemical compound that smells like rotting fish. The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. about the troublesome transformation from choline into trimethylamine (TMA) for more than 40 years, but that was long before we learned about its connection to heart disease. Ferguson JF. I try to come up with new topics that I find interesting based on the latest research. About a third of those who complain of bad body odor despite good personal hygiene test positive for the condition, but reducing or eliminating meat, egg, and dairy intake can be a real lifesaver. Choline is also present in lecithin supplements. Written By 2011 Apr 7;472(7341):57-63. Trimethylamine is the compound that gives fish the fishy odor. In fact, halibut generated over 53 times as much TMAO as eggs! The EPA Office of Resource Conservation and Recovery (ORCR) that publishes the SW846 test methods manual no longer uses the MDL, and promotes the use of the Lower Limit of Quantitation (LLOQ) approach for establishing the reporting limit for a respective test method or laboratory SOP. I would love to hear from you! What laboratories offer testing for trimethylaminuria. From a TMAO standpoint, we may not have to eat like a vegan as long as we poop like one. TRIMETHYLAMINE Label abbreviations descriptions TRIMETHYLAMINE * All sampling instructions above are recommended guidelines for OSHA Compliance Safety and Health Officers (CSHOs), please see the corresponding OSHA method reference for complete details. Trimethylaminuria [rarediseases.info.nih.gov] Conversion of choline methyl groups through trimethylamine into methane in the rumen. So, we need some, and we can get all we need in fruits, vegetables, beans, and nuts. Increased Weight Loss: Studies show that fasting can reduce body weight and body fat while also helping to retain muscle mass to improve body composition. You have been a wonderful help to me. downregulate the TMAO liver enzymenot enough to make you stinky, but just enough to drop TMAO. Below are the 9 best-proven ways I have found to lower your TMAO. 1. Fortunately, the K a and K b values for amines are directly related. We use cookies to make wikiHow great. Trimethylamine N-oxide (TMAO) is a metabolite generated from gut microbial degradation of choline, betaine, and carnitine. Yes. If only there were some other way we could stop this process from happening. The gut microbial endocrine organ: bacterially derived signals driving cardiometabolic diseases. Testing can be done by giving choline by mouth followed by urine collection a certain number of times over a 24 hour period. When researchers followed kidney patients over time and assessed their freedom from death, they found that those with higher TMAO lived significantly shorter lives, even after controlling for kidney function. You can give a vegan a steak, which contains both choline and carnitine, and there will not even be a bump in TMAO. What about probiotic supplements? Elevated TMAO could reflect dietary trimethylamine or TMAO from seafood, but it could also reflect impaired excretion into the urine, or enhanced conversion of trimethylamine to TMAO in the liver. Michael Greger M.D. wikiHow is where trusted research and expert knowledge come together. If you look back at the table further up the page, you will see that the trimethylamine has a much lower boiling point (3.5C) than 1-aminopropane (48.6C). So, hey, pharmacologic inhibition of the enzymes in our liver that make TMAO could potentially serve as a therapy for [cardiovascular disease] risk reduction. But, theres a genetic condition in which this enzyme is naturally impaired, called trimethylaminuria, in which there is a buildup of trimethylamine in the bloodstream. % of people told us that this article helped them. Reactivity Profile. Some people with trimethylaminuria have a strong odor all the time, but most have a moderate smell that varies in intensity over time. FOIA HHS Vulnerability Disclosure, NLM Support Center The invention relates to a method for determining content of triethylamine salt. Not all of these methods have worked for those with TMAU, as each person is different, but some have at least reduced the symptoms. Trimethylamine N-oxide (TMAO) is a dietary byproduct that is formed by gut bacteria during digestion. Take probiotics. Trimethylamine is notable for its unpleasant smell. One possible explanation for this paradox is that the TMAO produced from fish may be metabolized differently than TMAO from animal products. Taking low doses of antibiotics to reduce the amount of bacteria like trimethylamine in the gut Taking activated charcoal or other supplements to decrease the concentration of free trimethylamine in the urine Taking riboflavin (vitamin B2) supplements to enhance FMO3 enzyme activity. He completed his B.S. Copy the address found in the box above and paste into your favorite podcast application or news reader. So, Big Pharma developed statin drugs that. TMA is so stinky that it makes you smell like dead fish. Trimethylaminuria may be caused by a variety of genetic changes to the FMO3 gene. Thus, it is impossible to know if it was the dairy, or the actual fat calories, that boosted TMAO levels. Since spore probiotics are capable of surviving past the stomach acid in the gut, and play a central role in a healthy gut, they are my first line of defense when it comes to protecting from LPS. Not at all. To subscribe, select the "Subscribe via E-Mail" button above. #294 9 Ways to Lower Your TMAO Afib and Heart Disease Risk. But making changes in your diet, using certain soaps and lotions and managing stress can help reduce symptoms. Genetic testing is also available, though usually not necessary to make a diagnosis. Email: LabClientServices@childrenscolorado.org. Atherosclerosis. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions. Condition summary on trimethylaminuria from the Genetics Home Reference Web site. Trimethylamine builds up in the body of patients with trimethylaminuria. This page is no longer being updated as of February 28, 2023. Select the subscription method below that best fits your lifestyle. Be Cautious with Choline and Carnitine Supplements An individual pours pills into their hand They also said that taking baby aspirin can reduce the impact of tmao on platelets by 40%. Brugre JF, Borrel G, Gaci N, Tottey W, O'Toole PW, Malpuech-Brugre C. Archaebiotics: proposed therapeutic use of archaea to prevent trimethylaminuria and cardiovascular disease. Children's Hospital Colorado Trimethylamine Section 2. Finding Reliable Health Information Online Genetics Home Reference: Trimethylaminuria [ghr.nlm.nih.gov] By using our site, you agree to our. Do we need to worry about high-choline plant foods, like broccoli? Resveratrol was once the darling longevity food. Triethyl amine in a reaction can be removed by treating the reaction mixture with Conc. Vegetarians and vegans have different gut microbial communities. What if we introduce new bacteria that could somehow siphon off the TMA made by the bad bacteria already in our gut? If our intestinal bacteria and liver can make TMAO from meat, dairy, and eggs, should we destroy our gut flora? 2006 Nov;45(9):864-6. The good news is, though, that this opens up exciting new nutritional and interventional prospects for prevention. The chemical is derived in part from nutrients that are abundant in red meat. In that case, might the fact that, fecal contamination in every sample of beef it tested be a good thing? EPA ORCR is in the process of transitioning existing SW . Trimethylamine | (CH3)3N or C3H9N | CID 1146 - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities . It turns out that brussels sprouts appear to naturally downregulate the TMAO liver enzymenot enough to make you stinky, but just enough to drop TMAO. Our system absorbs the compound, and our liver oxidizes it into TMAO. People who eat completely plant-based may not, any TMAO at alleven if they try. Note: some of the resources below may be affiliate links, meaning I get paid a commission (at no extra cost to you) if you use that link to make a purchase. Phone: 720-777-6711 Information from the Genetics and Rare Diseases Information Center. I can answer general health questions and will do my best to answer your questions in my blogs, podcasts, or videos. If only there was some other way we could somehow stop this process from happening. If you really want to know your TMAO level, you can do a quick Google search and find many companies willing to help you with this. Gene testing is currently available only through research laboratories. TMAO is a toxic compound that may increase our risk of heart failure, kidney failure, and atherosclerosis, but might there be nutritional or interventional prospects for prevention? Are those on plant-based diet at risk or not and should they eat soy? Can you sense my frustration as I read paper after paper proposing ridiculous strategies for reducing or inhibiting TMAO production? It is important that a person who has trimethylamuinuria follow the treatment advice of their health care provider. An article about trimethylaminuria, written by Damaris Christensen, and published by ScienceNewsOnline, Volume 155, Number 20 (May 15, 1999), Effects of the dietary supplements, activated charcoal and copper chlorophyllin, on urinary excretion of trimethylamine in Japanese trimethylaminuria patients. Reduced clearance of uremic solutes and imbalance in gut bacteria increase IS, pCS, and TMAO levels in the serum of CKD and AKI patients [61] . These same foods raise our cholesterol, but dietary change isnt very profitable. If any changes are made to the original text or video, you must indicate, reasonably, what has changed about the article or video. Real Living. These core functions are linked to the production of essential and extremely diverse metabolites such as vitamins (vitamin B 12, folic acid or vitamin K), bile acids, neurotransmitters (serotonin, dopamine, acetylcholine) and SCFA (acetic acid, propionic acid and butyric acid). Dr. Greger has lectured at the Conference on World Affairs, testified before Congress, and was invited as an expert witness in the defense of Oprah Winfrey in the infamous meat defamation trial. Biochem J. After this, one or more samples of urine are collected (20 mL . When applied on the skin on a regular basis, acidic body lotions and soaps fully convert excreted TMA to the non-smelling conjugate acid, reducing the body odor. []It can also be used to prepare benzyltrimethylammonium chloride, which then reacts with sodium ethoxide to form benzyltrimethylammonium . Gut Microbes. that the more TMAO people had in their blood, the greater the odds they had heart disease and the worse their heart disease was. Note: This laboratory may have a long waiting list of patients. Human studies show that they improve the flow of blood through the vessels, which can reduce the risk for cardiovascular disease. If our gut bacteria can take meat, dairy, and eggs and turn them into TMAO, all we have to do is destroy our gut flora. We could give people antibiotics to eliminate the production of TMAO, but that could also kill our good bacteria and foster the emergence of antibiotic-resistant bacterial strains. Read our important information about translations here. Copyright 2023 Dr. John Day, LLC. The problem is, if it didnt take, youd have to keep giving it to people. For example, one study showed that TMAO levels came down by 60% with fiber. Last updated: They should not attempt to self-administer. Trimethylaminuria is a metabolic condition in which an individual is not able to convert trimethylamine into a compound called trimethylamine N-oxide. Pronunciation of trimethylamine oxide with 2 audio pronunciations. So, forget the cow. The same foodsmeat, dairy, and eggsraise our cholesterol, and changing our diet may lower it, but that isnt very profitable. Research source As mentioned above, our gut bacteria can turn choline into TMAO, too. [4] 4 Unfortunately at this time, enzyme replacement therapy with the enzyme FMO3, which when absent, is believed to cause the condition, is not an option in the management of trimethylaminuria. Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, Smith JD, DiDonato JA, Chen J, Li H, Wu GD, Lewis JD, Warrier M, Brown JM, Krauss RM, Tang WH, Bushman FD, Lusis AJ, Hazen SL. Trimethylamine (TMA) is the simplest tertiary aliphatic amine. Why not? So, given the known adverse effectsfrom sufferers of fish odor syndrome, the untoward odorous side effects of inhibiting this enzyme, Do we have to choose between suffering from heart and kidney disease or smelling like dead fish? Therefore, all plant and animal cells need choline to preserve their structural integrity [ 1, 2 ]. Many quality heart supplements contain it. . Copper chlorophyllin taken at a dose of 60mg three times a day after meals for three weeks. . As with any topic, you often find mixed results if you dig deep enough. Adding good bacteria doesnt seem to get rid of the bad. Genetics Home Reference: Trimethylaminuria, Online Mendelian Inheritance in Man (OMIM), Finding Reliable Health Information Online. Vegetarians and vegans have different gut microbial communities. A urine test is used to diagnose trimethylaminuria. Our system absorbs the compound, and our liver oxidizes it into TMAO. Has any study been done on the effect of acid blockers on gut bacteria? [1] Kind Regards In the Womens Health Initiative study, women with the highest TMAO levels in their blood had approximately three times greater risk of rectal cancer, suggesting that TMAO levels may serve as a potential predictor of increased colorectal cancer risk. true. For example, we know from countless studies that fish may protect against cardiovascular disease. A carrier of this condition can be identified by the "TMA challenge" or a "TMA load" test. Consumption of hawthorn fruit is believed to be cardio-protective, yet whether it is able to suppress the TMAO-induced atherosclerosis remains unexplored. Do we have to choose between suffering from heart and kidney disease or smelling like dead fish? Carnitine is a metabolite found in red meat. The bottom line is that if you choose to eat meat, make sure you also eat large amounts of vegetables to neutralize TMAO spikes. Many studies, but not all studies, have shown that probiotics may also reduce TMAO. Generally, people who suffer from Afib are nervous people and get stressed easily if they use it every day. Using an array of different technologies, the researchers determined that the more TMAO people had in their blood, the greater the odds they had heart disease and the worse their heart disease was. An electronic catalog of human genes and genetic disorders, developed by the National Center for Biotechnology Information (NCBI). The gasis corrosive and dissolves in water to form . University of Pennsylvania Neill AR, Grime DW, Dawson RM. 2014 Oct;124(10):4204-11. You may republish this material online or in print under our Creative Commons licence. Why does eluent strength increase as solvent becomes. Yamazaki H, Fujieda M, Togashi M, Saito T, Preti G, Cashman JR, Kamataki T. Life Sci, 74(22):2739-47. I was Googling to find out if eating soy is bad for this and came across an article about a study by doctor Zhu of Cleveland Clinic. However, eating fish causes a big rise in TMAO levels. Trimethylamine-N-oxide (TMAO) is an independent risk factor for atherosclerosis. You may not use our material for commercial purposes. Taking supplements to decrease the concentration of free trimethylamine in the urine. A new blood test that measures levels of TMAO (trimethylamine-N-oxide) a metabolite derived from gut bacteria can powerfully predict future risk for heart attack, stroke, and death in patients who appear otherwise healthy, according to pioneering Cleveland Clinic research. Shipped as a liquid under its own vapor pressure. Zhang X, Shu XO, Xiang YB, Yang G, Li H, Gao J, Cai H, Gao YT, Zheng W. Cruciferous vegetable consumption is associated with a reduced risk of total and cardiovascular disease mortality. In a study (RCT) of 3,000 individuals, those with lower TMG levels were more likely to have diabetes. TRIMETHYLAMINE, AQUEOUS SOLUTION neutralizes acids in exothermic reactions to form salts plus water. It is concentrated in red meat, certain energy drinks, and carnitine supplements. Well, there is a bacterium inside the guts of cows and sheep that turns trimethylamine into methane. In reversed-phase chromatography the solutes are nonpolar ad . To see what was going on, researchers took the vegetable highest in choline, brussels sprouts, and had people eat two cups a day for three weeks. Wash hands thoroughly after handling. Trimethylamine N-oxide (TMAO), an important proatherogenic uremic toxin, is oxidized by hepatic-flavin monooxygenases from gut microbiome-generated trimethylamine (TMA). Who Are at Risk of Producing Trimethylamine? The urine test can be done in two different ways. The language on this page about trimethylaminuria is technical but is considered to be a very comprehensive source of information. If you do a simple search for TMAO cardiovascular on Pubmed website, you will quickly come up with 248 studiesat the time of this writing. The new test now available through Cleveland HeartLab measures blood levels of TMAO, a compound produced . It is common to compare basicity's of amines by using the K a 's of their conjugate acids, which is the corresponding ammonium ion. Taking supplements to decrease the concentration of free trimethylamine in the urine. Indeed, one study showed that going 24 hours without sleeping could boost TMAO levels. Other. If we dont eat steak, then we dont. And, plant-based eating gives us other benefits: For more on TMAO, the smoking gun of diet-microbiome-disease interactions, see: A founding member and Fellow of the American College of Lifestyle Medicine, Michael Greger, MD, is a physician, New York Times bestselling author, and internationally recognized speaker on nutrition. General Description. How to Reduce LPS Naturally Spore Probiotics: The primary strategy to deal with endotoxemia is to support the integrity of the gut lining and gut mucosa. Tang WH, Hazen SL. Trimethylamine N-oxide is present in seafood (fish, cephalopods, crustaceans). Eat more healthfully. Yes, you can absolutely test for TMAO. for three years, and, as you can see in the. FACLM Yes, open heart surgery does take a toll on the heart and arrhythmias can be a long-term complication from the surgery. Symptoms of excessive trimethylamine can occur if the liver enzyme (flavin-containing monooxygenase 3) is unable to break down the substance. Having the right gut bacteria may help to prevent atrial fibrillation and just about every other form of cardiovascular disease. 7th Aug, 2019 It can be a lot of things. Limitations. Im currently talking a heart supp called MitoQ which supposedly gets CoQ10 directly into the mitochondria. But, it doesnt work. Trimethylamine has been described as smelling like rotten or decaying fish. Below is an approximation of this videos audio content. Scope: Trimethylamine N-oxide (TMAO), an important proatherogenic uremic toxin, is oxidized by hepatic-flavin monooxygenases from gut microbiome-generated trimethylamine (TMA). How to Lower TMAO? could there be a pre-biotic gut freindly to help eliminate this toxic bacteria? A cup of milk or yogurt already counts as one. However, eating the whole bean, like they do in Asia, appears to be very protective from cardiovascular studies done on these people. Well, what do those with trimethylaminuria often do to cut down trimethylamine levels? Dietary Cure for Hidradenitis Suppurativa. Archaea and the human gut: new beginning of an old story. Contact: Lab Client Services However, it is possible for people with this condition to live normal, healthy lives. To see what was going on, researchers took the vegetable highest in choline, Brussels sprouts, and had people eat two cups a day for three weeks, and their TMAO levels actually went down. Trimethylamine has also been prepared by a reaction of ammonium chloride and paraformaldehyde: [14] This compound is often associated with atherosclerosis and. Their TMAO levels actually went down. the ability of inflammatory cells within the atherosclerotic plaque in our artery walls to bind to so-called bad LDL cholesterol. Trimethylamine oxide (TMAO) is found largely in most marine fish; in contrast, its presence is negligible or nil in freshwater fish. Use only outdoors or in a well-ventilated area. from the Sackler School of Medicine, and a residency at Huntington Memorial Hospital, an affiliate of the University of Southern California. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. Okay, so how are we going to do it? No. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. A change of split ratio only affected the signal intensity of the analytes, and the amount of injected sample matrix remained the same. Trimethylamine (TMA) has been used in the preparation of poly[9,9-bis(6-N,N,N-trimethylammonium)hexyl)fluorene-co-alt-4,7-(2,1,3-benzothiadiazole) dibromide] (PFBT), a water-soluble, cationic conjugated polymer used in label-free DNA microarrays. Sharks, rays, and skates retain urea and trimethylamine oxide (TMAO) within their blood allowing them to become only slightly hyperosmotic thereby reducing the cost of osmoregulation. 2013 Jun;6(3):308-9. Trimethylaminuria, has been around for centuries, but has only gained scientific recognition and support in the past 30 years. Where can we find carnitine? From a TMAO standpoint, we may not have to eat like a vegan as long as we poop like one. National Center for Biotechnology Information, Lister Hill National Center for Biomedical Communications, Chemical Hazards Emergency Medical Management, https://www.phmsa.dot.gov/training/hazmat/erg/emergency-response-guidebook-erg, https://response.restoration.noaa.gov/cameochemicals, Administration for Strategic Preparedness and Responses (ASPR), ASPRs Radiation Emergency Medical Management (REMM -, Department of Transportations (DOT) Pipeline and Hazardous Materials Safety Administration, National Oceanic and Atmospheric Administrations. Urine testing should be performed on two separate occasions when the individual is on a non-restricted diet. Great question. From a practical standpoint, if you can optimize around the 9 ways to lower your TMAO Afib and heart disease risk, then your TMAO levels will probably be undetectable even if you wanted to do TMAO testing. In the Womens Health Initiative study, women with the highest TMAO levels in their blood. Jim, It can be a challenge. In women, symptoms can worsen just before and during menstrual periods, after taking oral contraceptives, and around menopause. To get more resveratrol in your diet be sure to eat peanuts, berries, grapes, nuts, and dark chocolate. Likewise, dairy studies arent 100% entirely clear either. immediately or shortly after exposure to Trimethylamine: * Contact can irritate and burn the skin and eyes. Online Mendelian Inheritance in Man (OMIM) [omim.org] What happened? [3] 3 Take supplements. Indeed, studies show that people who don't eat meat, dairy, or eggs can virtually eliminate TMAO from their blood.