Also to detox the body Therasage.com they produce a full spectrum infrared Sauna with no EMF The name of the man that designed and produce it in America is Robby Besner and it is manufactured in America. The condition seems to be more common in women than men, but scientists don't know why. 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. The simplest point of intervention is to [just] limit [the] consumption of foods rich in choline and L-carnitine, which can be an effective strategy to limit circulating TMAO. Four thousand people were followed for three years, and, as you can see in the graph below and at 3:10 in my video Egg Industry Response to Choline and TMAO, those with the highest TMAO levels went on to have significantly more heart attacks, strokes, or even death. If only there was some other way we could somehow stop this process from happening. We could, but if it didnt take, if our gut didnt become colonized by the cow-and-sheep bacterium, wed have to keep introducing it to our body. Wash hands thoroughly after handling. To make sure you do not miss my answer to your question, please sign up for my newsletter. Trimethylamine is a strong base (pH 9.8), thus soaps with pH closer to that of normal skin help retain the secreted trimethylamine in a less volatile form that can be removed by washing. How about probiotic supplements? The bottom line is that if you choose to eat meat, make sure you also eat large amounts of vegetables to neutralize TMAO spikes. You may not use our material for commercial purposes. From a TMAO standpoint, maybe we dont have to eat like a vegan, as long as we poop like one. The same foodsmeat, dairy, and eggsraise our cholesterol, and changing our diet may lower it, but that isnt very profitable. Cashman JR, Xiong Y, Lin J, Verhagen H, van Poppel G, van Bladeren PJ, Larsen-Su S, Williams DE. Regarding soy, the data are limited at best and I couldnt determine if it was a soy isolate, like that found in processed food, or the whole bean. From a TMAO standpoint, we may not have to eat like a vegan as long as we poop like one. Carriers of trimethylaminuria excrete 20-30 percent of total trimethylamine as the free unmetabolized amine and the rest as trimethylamine N-oxide. 2006 Nov;45(9):864-6. They should not attempt to self-administer. You may not apply legal terms or technological measures that restrict others from doing anything permitted here. Clin Pediatr (Phila). However, given all of the other potentially harmful effects of antibiotics, this is not a viable option. How to Reduce Trimethylamine N-Oxide (TMAO) Levels We've established that elevated trimethylamine N-oxide levels are simply a reflection of a disruption in the overall homeostasis of your body. Scope: Trimethylamine N-oxide (TMAO), an important proatherogenic uremic toxin, is oxidized by hepatic-flavin monooxygenases from gut microbiome-generated trimethylamine (TMA). From a TMAO standpoint, we may not have to eat like a vegan as long as we poop like one. Be Cautious with Choline and Carnitine Supplements An individual pours pills into their hand Acid soaps and body lotions to remove secreted trimethylamine by washing; Activated charcoal and copper chlorophyllin to sequester trimethylamine produced in the gut; Antibiotics (metronidazole, amoxicillin, and neomycin) to suppress production of trimethylamine by reducing bacteria in the gut; Are those on plant-based diet at risk or not and should they eat soy? 1 rating. 2013 May;19(5):576-85. Choline is also present in lecithin supplements. 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. TMAO may be a key dietary component of an unhealthy diet that contributes to disease promotion. Annu Rev Med. However, eating the whole bean, like they do in Asia, appears to be very protective from cardiovascular studies done on these people. When we eat foods with high concentrations of choline, a nutrient I discuss in more detail below, certain bacteria in our gut make trimethylamine, or TMA. 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. 2011 Nov;124(11):1058-63. The gut microbial endocrine organ: bacterially derived signals driving cardiometabolic diseases. Biochem Pharmacol. 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. There is a growing body of clinical evidence that supports a strong association between elevated circulating trimethylamine N-oxide (TMAO) levels with increased risk of developing adverse cardiovascular outcomes such as atherosclerosis and thrombosis.TMAO is synthesized through a meta-organismal stepwise process that involves (i) the microbial production of TMA in the gut from . Carnitine is a metabolite found in red meat. The language on this page about trimethylaminuria is technical but is considered to be a very comprehensive source of information. As far as the gallbladder and aspirin studies, these were just single studies and I dont know what to make of them. 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. Wise PM, Eades J, Tjoa S, Fennessey PV, Preti G. Individuals reporting idiopathic malodor production: demographics and incidence of trimethylaminuria. For example, we know from countless studies that fish may protect against cardiovascular disease. Thats the topic of my video How to Reduce Your TMAO Levels. The invention relates to a method for determining content of triethylamine salt. 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. Eat a diet very high in vegetables and avoid sugar and processed carbohydrates. Trimethylamine has been described as smelling like rotten or decaying fish. This field is for validation purposes and should be left unchanged. Gut Microbes. Recently, our group reported a topical odor-quenching formulation based on polymeric vesicles of the diblock poly (isoprene)- b-poly (ethylene glycol). Trimethylamine oxide (TMAO) is found largely in most marine fish; in contrast, its presence is negligible or nil in freshwater fish. A dosage of 750 mg of activated charcoal twice daily for 10 days has been shown to reduce urinary free TMA and shift the TMA:AO ratio to values similar to those seen in healthy patients. A carrier of this condition can be identified by the "TMA challenge" or a "TMA load" test. The present study was to investigate the effects of hawthorn fruit extract (HFE) on TMAO-exacerbated atherogenesis. Subscribe to our free newsletter and receive The Evidence-Based Eating Guide: A Healthy Living Resource from Dr. Greger and NutritionFacts.org. To do this study, research participants supplemented their diets with vast amounts of dairy and coconut milk. 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. In this article, Ill share 9 ways to lower your TMAO Afib and heart disease risk. So, we need some, and we can get all we need in fruits, vegetables, beans, and nuts. Trimethylamine-N-oxide (TMAO) is an independent risk factor for atherosclerosis. It's responsible for the pungent odor given off by fish and other marine and aquatic animals. Carnitine and choline are two components known to facilitate production of TMAO. Symptoms of excessive trimethylamine can occur if the liver enzyme (flavin-containing monooxygenase 3) is unable to break down the substance. Kathleen, I was taking acid blockers for over 10 years. Trimethylamine N-oxide is present in seafood (fish, cephalopods, crustaceans). 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. that the more TMAO people had in their blood, the greater the odds they had heart disease and the worse their heart disease was. This time to make a fair comparison you would have to compare trimethylamine with its isomer 1-aminopropane. 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. May be incompatible with isocyanates, halogenated organics, peroxides, phenols (acidic), epoxides, anhydrides, and acid halides. Within 24 hours of consumption of carnitine, certain gut bacteria metabolize it into TMA, which our liver then oxidizes into the TMAO that then circulates throughout our bloodstream. Below are the 9 best-proven ways I have found to lower your TMAO. The enzyme Fmo3 carries out this conversion, mainly in the liver, as reviewed here. Unfortunately, due to federal privacy laws, I am unable to answer any questions about your specific medical condition. Below is an approximation of this videos audio content. Higher exposures can cause a build-up of fluid in the lungs (pulmonary edema), a 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. Ferrari ND 3rd, Nield LS. He has over 16 years of medical training and facilitation and is a Diplomate of the American Board of Internal Medicine. 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. We could, but if it didnt take, if our gut didnt become colonized by the cow-and-sheep bacterium, wed have to keep introducing it to our body. . 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. We use cookies to make wikiHow great. In women, symptoms can worsen just before and during menstrual periods, after taking oral contraceptives, and around menopause. Copy the address found in the box above and paste into your favorite podcast application or news reader. An electronic catalog of human genes and genetic disorders, developed by the National Center for Biotechnology Information (NCBI). That doesnt work. The person's urine is tested to look for higher levels of trimethylamine. This is the enzyme that converts trimethylamine to to trimethylamine N-oxide. Although I try to eat healthy food, I think my gut bacteria is way off the scale. Choline is a source of methyl groups needed for many steps in metabolism. use anti-perspirant wash your clothes frequently Treatments from a doctor Your doctor may recommend: short courses of antibiotics - this can help reduce the amount of trimethylamine produced in your gut taking certain supplements - such as charcoal or riboflavin (vitamin B2) Support Many people find living with trimethylaminuria difficult. 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. Click the card to flip . 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. Because these methylamines might form nitrosamines, which have cancer-causing activity. []It can also be used to prepare benzyltrimethylammonium chloride, which then reacts with sodium ethoxide to form benzyltrimethylammonium . TRIMETHYLAMINE, AQUEOUS SOLUTION neutralizes acids in exothermic reactions to form salts plus water. In fact, halibut generated over 53 times as much TMAO as eggs! Many studies, but not all studies, have shown that probiotics may also reduce TMAO. it said that even vegans and vegetarians can have this undesirable substance due to its being put out by the gallbladder or something to that effect . All rights reserved. Not yet although Ill bet that many pharmaceutical and supplement companies are probably working on it, I found the article on TMAO very interesting but when I went to Google a blood test which could be bought online I really couldnt find an companies available. Makes me think of so many parallels, not the least of which are: For more on TMAO, the smoking gun of diet-microbiome-disease interactions, see: If you havent yet, you can subscribe to my videos for free by clicking here. Has any study been done on the effect of acid blockers on gut bacteria? A urine test is used to diagnose trimethylaminuria. Thank you for sharing your knowledge. Additionally, using supplements or medications that lower trimethylamine levels can also be effective. It is also a degradation product of plants that have high nitrogen contents and a distillation product of sugarbeet residues. Generally, people who suffer from Afib are nervous people and get stressed easily if they use it every day. Recommended intake is 30-40mg taken 3-5 times per day with food. One unexplained paradox of TMAO is fish consumption. Yamazaki H, Fujieda M, Togashi M, Saito T, Preti G, Cashman JR, Kamataki T. Life Sci, 74(22):2739-47. Interestingly, antibiotics completely destroy TMAO producing bacteria. Until the science is better understood it is probably best to minimize any supplements that havent fully been studied. Carnitine, Choline, Cancer, and Cholesterol: The TMAO Connection, How Our Gut Bacteria Can Use Eggs to Accelerate Cancer. Two major enzymes including oxidoreductase and TMAO demethylase reduce TMAO to trimethylamine (TMA) during postmortem changes and associated biochemical and microbial reactions in fish muscle. However, they accept samples from people in the United States. The gasis corrosive and dissolves in water to form . This website does not create a doctor-patient relationship between you and Dr. John Day. They stop eating animal products. As my A-Fib is caused by scar tissue(prior open heart surgery) will any changes to living style help? Do we need to worry about high-choline plant foods, like broccoli? Not at all. Trimethylamine is notable for its unpleasant smell. Catch up with Dr. Greger at one of his live speaking engagements: Due to the pandemic, my speaking tour has been postponed until the release of my next book in 2024. Probiotics can help with GERD or reflux. Adding good bacteria doesnt seem to get rid of the bad. Last Updated: October 27, 2022 . TMAO is a toxic byproduct from an unhealthy gut microbiome. Once these bad gut bacteria have been eliminated, a vegan could even eat an occasional steak and not get a TMAO spike. Gene testing is currently available only through research laboratories. [4] 4 Real Living. 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. Please considervolunteeringto help out on the site. How to Reduce TMAO Levels Consider a TMAO Test to Gauge Your TMAO Levels Limit Your Consumption of Foods High in TMAO Decrease Your Intake of Red Meat to Reduce Risk of Heart Disease Eat More Vegetables to Bring Down TMAO Levels Consider a Mediterranean Diet Since It's Very Balanced Be Cautious About Supplements as This Can Shoot Up TMAO Levels In fact, consumption of cruciferous vegetables is associated with a significantly, cardiovascular disease mortality, as you can see at 5:34 in my, the vegetable highest in choline, brussels sprouts, and had people, two cups a day for three weeks. Reactivity Profile. 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. Taking laxatives can decrease intestinal transit time and reduce the amount of trimethylamine produced in the gut. Exercise every day. While resveratrol has lost its longevity luster, it may reduce TMAO. Maintain a lean healthy weight. Trimethylamine builds up in the body of patients with trimethylaminuria. [Full Text] [ncbi.nlm.nih.gov]. 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. The field is rapidly developing and further research is required to see if the results are real or not. Some people with trimethylaminuria have a strong odor all the time, but most have a moderate smell that varies in intensity over time. Photosynthetic response curves examine photosynthetic rates and maximum irradiance. The problem with that is that trimethylamine is so stinky, it makes you smell like dead fish. So, given the known adverse effectsfrom sufferers of [this] fish odor syndrome, the untoward odorous side effectsmake it a less attractive [drug] target. So, do we have to choose between smelling like dead fish, or suffering from heart and kidney disease? If you have trimethylaminuria or high levels of TMAO, you may be able to reduce the presence of the compounds in the body with the following: 1. 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. What about probiotic supplements? Cruciferous vegetable consumption is associated with a significantly longer life:less cardiovascular disease mortality. Genetic testing is also available, though usually not necessary to make a diagnosis. Check the concentration of the sample, injection volume, solvent you are using to prepare your sample, cycle time and scan time if using MS, all the fitings. High levels of this compound are tied to coronary artery disease, so this may help reduce your risk. Should we give that a try to lower our TMAO levels? 7 min read. Not all of these methods have worked for those with TMAU, as each person is different, but some have at least reduced the symptoms. Do we need to, about high-choline plant foods, like broccoli? 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. Urine testing should be performed on two separate occasions when the individual is on a non-restricted diet. Why not pharmacologically inhibit the enzymes in our liver that make TMAO and thereby possibly help reduce our risk of cardiovascular disease? You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. Indeed, one study showed that going 24 hours without sleeping could boost TMAO levels. The trimethylamine gets released in the person's sweat, urine, reproductive fluids, and breath, giving off a strong fishy odor. 2014 Oct;124(10):4204-11. 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. good bacteria, might they crowd out the bad bacteria? If anyone knows where you can buy a test for TMAO and have the blood drawn locally please let me know. TMG supplementation can cause a person's urine and sweat to smell fishy . 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. Therefore, all plant and animal cells need choline to preserve their structural integrity [ 1, 2 ]. Real Food. So, maybe we could use the bacteria to get rid of some of it from our gut, like a cow fecal transplant. Increasing the split ratio from 1:5 to 1:10 did not reduce the recoveries of DMSO to normal range, which is as predicted because the injected amount into the GC inlet was the same. A regular 24-hour fast may help reducetrimethylamine N-oxide levels in the long term. You have been a wonderful help to me. This page is no longer being updated as of February 28, 2023. taking a laxative to lessen the time that food takes to pass through the digestive tract, which can help reduce the amount of trimethylamine that the gut produces if possible, avoiding. Enter your email address to receive updates about the latest advances in genomics research. This laboratory is located in Canada. However, it is possible for people with this condition to live normal, healthy lives. Improved Heart Health: According to a study published in PLoS One, fasting is effective at improving cholesterol levels, which could potentially help reduce the risk of heart disease. Trimethylaminuria is a metabolic condition in which an individual is not able to convert trimethylamine into a compound called trimethylamine N-oxide. Trimethylamine N-oxide (TMAO) is a metabolite generated from gut microbial degradation of choline, betaine, and carnitine. Trimethylaminuria is diagnosed by a urine test. Dr. John Day is not responsible for any losses, damages or claims that may result from your medical decisions. Don. Our body makes all of the carnitine we need, so we can completely eliminate it from our diet. By signing up you are agreeing to receive emails according to our privacy policy. Image credit: Sally Plank via Flickr. FACLM Taking supplements to decrease the concentration of free trimethylamine in the urine. The contributory role of gut microbiota in cardiovascular disease. Eat a Mostly Plant-Based Diet As TMAO is made by having the wrong gut bacteria, the quickest way to reduce TMAO is to eliminate the source. Dr. Nazarian specializes in comprehensive physical examinations, IV Vitamin therapies, hormone replacement therapy, weight loss, platelet rich plasma therapies. General Description. We could. He completed his B.S. So, Big Pharma developed statin drugs that cripple the enzyme in our liver that makes cholesterol. So, given the known adverse effectsfrom sufferers of fish odor syndrome, the untoward odorous side effects of inhibiting this enzyme make it a less attractive [drug] target.. As TMAO is made by having the wrong gut bacteria, the quickest way to reduce TMAO is to eliminate the source. Copper chlorophyllin taken at a dose of 60mg three times a day after meals for three weeks. Non-carriers excrete less than 13% of the dose as trimethylamine. The TMA just doesnt get oxidized into TMAO. false. Great question. Major dietary sources of choline are eggs, milk, and meat, including liver, poultry, shellfish, and fish. Okay, so how are we going to do it? 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. Read our important information about translations here. Information from the Genetics and Rare Diseases Information Center. 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. Adding good bacteria doesnt seem to get rid of the bad. 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). 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. Our system absorbs the compound, and our liver oxidizes it into TMAO. If you have any questions, please Contact Us. Human studies show that they improve the flow of blood through the vessels, which can reduce the risk for cardiovascular disease. 2011 Jul;94(1):240-6. National Library of Medicine Or subscribe with your favorite app by using the address below: To subscribe, select the "Subscribe on iTunes" button above. Since this condition usually requires two altered genes to cause symptoms, typically neither parent of an individual with trimethylaminuria has any symptoms. There are several reports that the condition worsens around puberty. preti@monell.org Yes, you can absolutely test for TMAO. HCl . These studies are of interest, Dr. Hazen notes, because they identify a new set of microbial targets to help curb the TMAO generation in response to dietary L-carnitine. Choline, on the other hand, is an essential nutrient, so we do need somebut we dont need to get it from eggs. Circ Cardiovasc Genet. This image has been modified. Currently, NHGRI is not conducting studies on Trimeththylaminuria. Busby MG, Fischer L, da Costa KA, Thompson D, Mar MH, Zeisel SH. Kind Regards The following laboratories are able to assist in the diagnostic testing of patients who may have trimethylaminuria. 1 / 9. Indeed, this study showed that TMAO independently predicted susceptibility to atrial fibrillation outside of all the traditional Afib risk factors. FOIA HHS Vulnerability Disclosure, NLM Support Center Given what we know about how toxic TMAO can be, cutting down on animal products may not just save the social lives of people with a rare genetic disorder, but it could help save everyone elses actual lives. If you have a medical problem, immediately contact your healthcare provider. For example, one study showed that TMAO levels came down by 60% with fiber. But, wait, we could always try to genetically engineer a bacteria that eats up trimethylamine, but the simplest, safest recommendation may just be to eat healthier. Therefore, it is recommended that you work with a medical or genetics professional to contact the laboratories for further information. Trimethylaminuria may be caused by a variety of genetic changes to the FMO3 gene. 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. Am J Med. As with any topic, you often find mixed results if you dig deep enough. People with trimethylaminuria have an impaired version of the enzyme flavin-containing monooxygenase 3 (FMO3). One possible explanation for this paradox is that the TMAO produced from fish may be metabolized differently than TMAO from animal products. 7th Aug, 2019 It can be a lot of things. Choline- and betaine-defined diets for use in clinical research and for the management of trimethylaminuria. true. the ability of inflammatory cells within the atherosclerotic plaque in our artery walls to bind to so-called bad LDL cholesterol. Tripolt NJ, Leber B, Triebl A, Kfeler H, Stadlbauer V, Sourij H. Effect of Lactobacillus casei Shirota supplementation on trimethylamine-N-oxide levels in patients with metabolic syndrome: An open-label, randomized study. 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. Phone: 215-898-4713 Trimethylaminuria (TMAU, Fish Odor Syndrome) Trimethylaminuria, or TMAU, is a very rare condition that makes your sweat, breathe, saliva and pee smell like rotten fish or rotten eggs. Probiotics can help control the populations of neutral, opportunistic or pathogenic microbes so that less TMA is released from foods and drinks. TMA is so stinky that it makes you smell like dead fish. Supplemental materials for: Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Trimethylamine (TMA) is the simplest tertiary aliphatic amine. As with LDL cholesterol and many other potentially toxic substances, a high fiber diet dramatically drops TMAO levels. . Email: LabClientServices@childrenscolorado.org. the enzyme in our liver that makes cholesterol. As your gut microbiome tries to break down lecithin and carnitine from meat, eggs, dairy, processed foods, some energy drinks, some supplements, and soy TMAO is increased. Methane-producing bacteria may be able to eat up our TMAO, but, unfortunately, these bacteria may be associated with a variety of diseases, from gum disease down to colorectal cancer, as you can see at 2:15 in my video. Copyright 2023 Dr. John Day, LLC. Modern science puts its mark on a rare but ancient body-odor disease Diplomate, American Board of Internal Medicine. 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?