TRIMETHYLAMINURIA
(TMAU)
Have you ever forgotten to apply your underarm deodorant or antiperspirant and went to work or a party? I’m sure you remembered how uncomfortable that felt. You probably kept sniffing yourself or asking others if you stink. The recourse of this misdemeanour can be rectified by purchasing an odour fighter at a nearby shop or simply returning
deodorant or antiperspirant
home to apply your confidence in a tube.
Unfortunately, this is not such an easy fix for someone suffering from the condition called Trimethylaminuria (TMAU), also known as “fish odour syndrome”. This is a rare metabolic failure disorder which affects one to two per cent of the world’s population, with women accounting for the majority of sufferers. For varying reasons, persons affected by offensive body odour (BO) is a result of the chemicals in the cleansing products reacting negatively to the bacteria found on the skin, and can also exit through the mouth causing bad breath.
External uses of plant essences or “essential oils”, have components effective enough to balance the nervous system while killing most of the odour-causing bacteria. Humans perspire to maintain homeostasis by keeping the body’s internal temperature at 98.6 degrees Fahrenheit. This is played out when the body’s temperature rises and the sweat gland produces water containing mostly uric acid and sodium to cool the body down. Sweating is typically heaviest on the forehead, upper lips, neck and chest. Perspiration itself, regardless of the type of sweat gland from which it originates, is odourless until it mixes with bacteria found on the skin. Sweating is an involuntary process, a response to the environment, or to psychological factors such as embarrassment or stress.
Sweat glands are found across the body; each has a tube for secreting sweat, and a narrow passage that carries sweat to the skin’s surface. Most people have about
three million sweat glands in two types: apocrine and eccrine glands. Apocrine glands mostly lie in heavily coiled and hairy areas (armpits, the nipples, pubic areas, and around the navel) located deep within the fatty tissues (subcutis). This is the gland that secretes the type of sweat associated with body odour, mostly under the armpits. Apocrine glands secrete a milky sweat into the upper portion of the hair follicle and from there to the skin surface (Carol A. Turkington and Jeffrey S.
Dover, MD).
The average person can use any soap to kill odour-causing bacteria, while someone struggling with extreme BO needs to be conscious of the pH level in their soap. C Failor (2000) informs that soap is made from sodium or potassium hydrosols which are inherently alkaline, which can be around 9pH.
‘Parfume’ is an artificial scent added to cosmetics to present a pleasant scent. Due to the makeup of this additive, intolerance can also trigger an offensive body odour. By adding essential oils such as palmarosa and orange, one can maintain the skin’s balance along with providing an uplifting scent, and eliminate most of the odour-causing bacteria found on the skin.
TMAU essentially means that the body is not breaking down choline found in foods we ingest. Through these precursors such as eggs, legumes, fish, cheese, some nuts, etc., the bacteria in the gut Trimethylamine (TMA) is produced. An enzyme called flavin contains the monooxygenase 3 FMO3 gene.This gene, when working effectively and along with other factors, is responsible for controlling the gut system and making sweat odourless. There is a varying concentration of TMA in urine; however, high concentrations emanate a strong fishy, pungent odour. Sewage, ammonia and even fecal scents can emit from some sufferers.
The complexity of this rare disorder continues since those affected, in most cases, are not aware they have an offensive BO, as sometimes their family members and spouses are unable to smell them due to ‘specific anosmia’(loss of potential smell). Some women are found to be affected close to and during their menstrual cycle. Along with oral contraceptives, menopause, having an autosomal hereditary trait, first outbreak at the onset of puberty, and liver damage, can be contributing factors.
Suspected TMAU case
A 37–year-old mother of one was told about the change in her BO by a friend. She recapped the ordeal to me and expressed her shock since she was wearing antiperspirant. While the friend visited her house frequently, she was perplexed about the source of the odour since the lady always practised good hygiene. It was characteristic of TMAU based on the symptoms: a fishy, raw and weird, slightly nauseating scent when she was close by, which nothing seemed to mask. Unknowingly, she was unaware of the lingering odour that was emanating from her body. She expressed that she was stressed personally and financially, which affected her sudden and untimely periods, and she was extremely moody along with severe headaches.
A recommendation to adjust her diet was made, an inhaler to target the stress and headaches with marjoram, lavender and cedarwood were developed. A natural deodorant was created for her that included geranium, cypress and bergamot. These essential oils have proven to address stress-related conditions while they kill odour-causing bacteria.
It has been proven through a study that when tea tree oil was added to the blend, it can cause further perspiration. Though this oil has strong antibacterial benefits, it is however found to be sudorific, endorsing the flow of sweat. The less sweat produced from the apocrine gland, the easier it will be to fight the bacteria under the arm.
The isolation felt by sufferers of TMAU is unfathomable and can be socially crippling. The inability to keep a job because of the disease is not understood and lack of hygiene is often suspected. They shower often not realising that the very soap creates a conundrum. Playing sports can be challenging since sweat would infuriate persons near and not so nearby. There is some hope as a “scent buddy” has worked for some, having a friend or trusted partner to discreetly and respectfully notify you when there is an emitted smell.
Being properly diagnosed since some doctors refer their clients to psychiatrists though TMAU is linked to the inactivity of the FMO3 enzyme causing TMA to leave the body with a range of scents, we have to admit that emotions play an integral role in exacerbating this condition. The sufferers are constantly consuming themselves with thoughts and worries of their probable smell; if someone scratches their nose they assume it is because of them. Though this might not be the case, the damage is done to the apocrine glands producing ‘stress sweat’ continuing a conundrum.
When used in moderation and with specific instructions, here are some essential oils that are beneficial to sufferers of TMAU: – Juniper berry is great to target paranoia -A body cream including the versatile geranium can be used to trap and kill the bacteria on the skin and can be applied after a shower.
– Clary sage can be used intermittently.
Consideration should always be given to the possibility of over sensitivity and phototoxicity when using essential oils.
It is imperative that essential oils are not used without the necessary carrier oils, yet there is indeed hope as Aromatherapy Matters!
