The fish odour syndrome: biochemical, familial, and clinical aspects.
Open accessAbstract
OBJECTIVES--To study the biochemical, familial, and clinical features of the fish odour syndrome among subjects with suspected body malodour. DESIGN--Subjects who responded to a newspaper article were screened for the fish odour syndrome by interview and biochemical tests. Families of subjects with the syndrome were tested if possible. SETTING--St Mary's Hospital, London, and some interviews at subjects' homes. SUBJECTS--187 subjects (28 males) with suspected body malodour, of whom 156 (19 males) underwent biochemical tests. Five families of six of the subjects with the fish odour syndrome agreed to further tests. MAIN OUTCOME MEASURES--Amounts of trimethylamine and trimethylamine N-oxide in urine collected over 24 hours under normal dietary conditions and for eight hours after oral challenge with 600 mg trimethylamine. RESULTS--The fish odour syndrome was diagnosed in 11 subjects: the percentage of total trimethylamine excreted in their urine samples that was oxidised to trimethylamine N-oxide was < 55% under normal dietary conditions and < 25% after oral challenge with trimethylamine (in normal subjects > 80% of trimethylamine was N-oxidised). Parents of six of the subjects with the syndrome were tested: all showed impaired N-oxidation of excreted trimethylamine (< 80%) after oral challenge, indicating that they were heterozygous carriers of the allele for the syndrome. The syndrome was associated with various psychosocial reactions including clinical depression. CONCLUSIONS--The fish odour syndrome can be inherited in an autosomal recessive fashion. It should be considered as a possible causative factor in patients complaining of body malodour.
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People with an inherited FMO3 defect can have very high TMA levels, causing the bad body odor of fish odor syndrome or trimethylaminuria.
“Previous studies have shown that subjects with a genetic defect in FMO3 can have markedly elevated TMA levels, leading to a noxious body odor that characterizes the condition (fish odor syndrome or trimethylaminuria [TMAU]) (83,84).”
From The contributory role of gut microbiota in cardiovascular disease (2014) · cites this paper as [84]
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TRIMETHYLAMINURIA: THE FISH-ODOUR SYNDROME
Humbert, J. R., Hammond, K. B., Hathaway, W., Marcoux, J., & OʼBrien, D. (1970) · The Lancet · doi:10.1016/s0140-6736(70)90241-2 · Cited by 166 · see citing works
Pharmacogenetics of Drug Metabolism
Flockhart, D. A., & Desta, Z. (2009) · Elsevier eBooks · doi:10.1016/b978-0-12-373639-0.00021-2 · Cited by 151 · see citing works
The metabolism of<sup>14</sup>C-labelled trimethylamine and its<i>N</i>-oxide in man
Al-waiz, M., Mitchell, S. C., Idle, J. R., & Smith, R. L. (1987) · Xenobiotica · doi:10.3109/00498258709043962 · Cited by 143 · see citing works
Self-citationA Genetic polymorphism of the N-oxidation of trimethylamine in humans
Al-Waiz, M. M., Ayesh, R., Mitchell, S. C., Idle, J. R., & Smith, R. L. (1987) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.1987.201 · Cited by 111 · see citing works
Self-citationCloning, primary sequence, and chromosomal mapping of a human flavin-containing monooxygenase (FMO1)
Dolphin, C. T., Shephard, E. A., Povey, S., Palmer, C. N., Ziegler, D. M., Ayesh, R., Smith, R. L., & Phillips, I. R. (1991) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)98908-8 · Cited by 90 · see citing works
Self-citationZhang, A. Q., Mitchell, S. C., Ayesh, R., & Smith, R. L. (1992) · Journal of Chromatography B Biomedical Sciences and Applications · doi:10.1016/0378-4347(92)80569-c · Cited by 74 · see citing works
Self-citationTrimethylaminuria: The detection of carriers using a trimethylamine load test
Al-Waiz, M. M., Ayesh, R., Mitchell, S. C., Idle, J. R., & Smith, R. L. (1988) · Journal of Inherited Metabolic Disease · doi:10.1007/bf01805534 · Cited by 59 · see citing works
Self-citationDolphin, C. T., Shephard, E. A., Povey, S., et al. (1992) · Biochemical Journal · doi:10.1042/bj2870261 · Cited by 53 · see citing works
Trimethylaminuria (‘fish-odour syndrome’): A study of an affected family
Al-Waiz, M. M., Ayesh, R., Mitchell, S. C., Idle, J. R., & Smith, R. L. (1988) · Clinical Science · doi:10.1042/cs0740231 · Cited by 45 · see citing works
Self-citationGenetic polymorphism of trimethylamine N-oxidation
Ayesh, R., & Smith, R. L. (1990) · Pharmacology & Therapeutics · doi:10.1016/0163-7258(90)90074-c · Cited by 37 · see citing works
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Research works printed but not linked: 16
- Boquet J, Boismare F, Payenneville G, Leclerc D, Monnier J-C, Moore N. Lateralization of headache: possible role of an upper cervical trigger point. Cephalalgia 1989;9:15-24.
- Maimaris C, Barnes MR, Allen MJ. "Whiplash injuries" of the neck: a retrospective study. Injury 1988;19:393-6.
- Martin PR, Nathan PR, Milech D, van Keppel M. The relationship between headaches and mood. Behav Res Ther 1988;26:353-6.
- Arena JG, Blanchard EB, Andrasik F. The role of affect in the etiology of chronic headache.J7Psychosom Res 1984;28:79-86.
- Pearce JMS, Whiplash injury a reappraisal. J Neurol Neurosurg Psychiatry 1989;52:1329-31.
- Hirsch SA, Hirsch PJ, Hiramoto H, Weiss A. Whiplash syndrome: fact or fiction? Orthop Clin NorthAm 1988;19:791-5.
- Dvorak J, Valach L, Schmid S. Cervical spine injuries in Switzerland. Orthopade 1987;16:2-12.
- Deans GT, Magalliard JN, Kerr M, Rutherford WH. Neck sprain-a major cause of disabilityfollowing car accidents. Iniury 1987;18:10-2.
- Zersson von D. Self-rating scales in the evaluation of psychiatric treatnent. In: Helgason T, ed. Methodology in the evaluation of psychiatric treatnent. Cambridge: Cambridge University Press, 1983:183-204.
- Watson D, Pennebaker JW. Health complaints, stress, and distress: exploring the cental role ofnegative affectivity. Psychol Rev 1989;96:234-54.
- Radanov BP, Dvorak J, Valach L Cognitive deficits in patients after soft tissue injury ofthe cervical spine. Spine 1992;17:127-31.
- Kelly R. Headache after cranial trauma. In: Hopkins A, ed. Headache. Problems in diagnosis and management. London: Saunders, 1988:217-40.
- Iance WJ. Fifty years ofmigraine research. AustNZJMed 1988;18:311-7.
- Martin PR, Marie GV, Nathan PR. Psychophysiological mechanisms of chronic headache: investigation using pain induction and pain reduction procedures. JPsychosom Res 1992;36:137-48. (Accepted 13Jldy 1993)
- Willey GR Trimethylamine-a pungent experience. Education in Chemistry 1985;22: 178-8 1.
- Al-Waiz M, Mitchell SC, Idle JR, Smith RL. The metabolism of '4C-labelled trimethylamine and its N-oxide in man. Xenobiotica 1987;17:551-8.
Cited by
Sorted by citations
Fennema, D., Phillips, I. R., & Shephard, E. A. (2016) · Drug Metabolism and Disposition · doi:10.1124/dmd.116.070615 · Cited by 355 · see citing works
Missense mutation in flavin-containing mono-oxygenase 3 gene, FMO3, underlies fish-odour syndrome
Dolphin, C. T., Janmohamed, A., Smith, R. L., Shephard, E. A., & Phillips, L. R. (1997) · Nature Genetics · doi:10.1038/ng1297-491 · Cited by 284 · see citing works
Self-citationTrimethylamine N‐oxide: breathe new life
Subramaniam, S., & Fletcher, C. (2018) · British Journal of Pharmacology · doi:10.1111/bph.13959 · Cited by 171 · see citing works
Fish odour syndrome: Verification of carrier detection test
Zhang, A. Q., Mitchell, S., & Smith, R. (1995) · Journal of Inherited Metabolic Disease · doi:10.1007/bf02436755 · Cited by 44 · see citing works
Self-citationTrimethylaminuria: An under‐recognised and socially debilitating metabolic disorder
Christodoulou, J. (2012) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2010.01978.x · Cited by 32 · see citing works
- Authors
- Ayesh, R., Mitchell, S. C., Zhang, A., & Smith, R. L.
- Affiliations
- St Mary's Hospital (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1993-09-11
- Volume
- 307
- Issue
- 6905
- Pages
- 655-657
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W2066652584
- Cited by
- 160
- References
- 10
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 10 · 2021: 4 · 2020: 7 · 2019: 2 · 2018: 1 · 2017: 9 · 2016: 5 · 2015: 2 · 2014: 2 · 2013: 4 · 2012: 3
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Medicine › Physiology › Sympathectomy and Hyperhidrosis Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Keywords
- trimethylamine, trimethylamine N-oxide, autosomal recessive inheritance, familial inheritance, heterozygous carriers, oral challenge, urinary excretion, major depressive disorder, psychosocial reactions
- MeSH terms
- Adolescent, Adult, Animals, Mental Disorders, Female, Fishes, Humans, Infant, Male, Metabolism, Inborn Errors, Methylamines, Odorants, Pedigree, Syndrome
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