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Trimethylaminuria

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Copyright 1994, 1995, 1999, 2005

NORD is grateful to Elizabeth Shephard, PhD, Professor of Molecular Biology, Department of Biochemistry and Molecular Biology, University College London, for assistance in the preparation of this report.

Synonyms of Trimethylaminuria
  • Fish Odor Syndrome
  • Flavin Containing Monooxygenase 3
  • FMO3
  • FMO, Adult Liver Form
  • Stale Fish Syndrome

Disorder Subdivisions



General Discussion
Trimethylaminuria is a rare disorder in which the body’s metabolic processes fail to alter the chemical trimethylamine. Trimethylamine is notable for its unpleasant smell. It is the chemical that gives rotten fish a bad smell. When the normal metabolic process fails, trimethylamine accumulates in the body, and its odor is detected in the person’s sweat, urine and breath. The consequences of emitting a foul odor can be socially and psychologically damaging among adolescents and adults. The genetic or primary form of this disorder is transmitted as an autosomal recessive trait.

A secondary form of trimethylaminuria may result from the side effects of treatment with large doses of the amino acid derivative L-carnitine (levocarnitine). The metabolic deficiency occurs as a result of a failure in the cell to make a specific protein, in this case, the enzyme flavin-containing monooxygenase3. Enzymes are nature’s catalysts and act to speed up biochemical activities. Without this enzyme, foods containing carnitine, choline and/or trimethylamine-N-oxide are processed to trimethylamine and no further, causing a strong fishy odor. This secondary form of the disorder is a result of an overload of trimethylamine. In this case, there is not enough of the enzyme to get rid of the excess trimethylamine.

Organizations related to Trimethylaminuria
  • CLIMB (Children Living with Inherited Metabolic Diseases)
    Climb Building
    176 Nantwich Road
    Crewe Intl CW2 6BG
    Phone #: +44- 87-0 7700 325
    800 #: --
    e-mail: info.svcs@climb.org.uk
    Home page: http://www.CLIMB.org.uk
  • Genetic and Rare Diseases (GARD) Information Center
    PO Box 8126
    Gaithersburg MD 20898-8126
    Phone #: 301-251-4925
    800 #: 888-205-2311
    e-mail: ordr@od.nih.gov
    Home page: http://rarediseases.info.nih.gov/Default.aspx
  • MUMS (Mothers United for Moral Support, Inc) National Parent-to-Parent Network
    150 Custer Court
    Green Bay WI 54301-1243
    Phone #: 920-336-5333
    800 #: 877-336-5333
    e-mail: mums@netnet.net
    Home page: http://www.netnet.net/mums/
  • Madisons Foundation
    PO Box 241956
    Los Angeles CA 90024
    Phone #: 310-264-0826
    800 #: N/A
    e-mail: getinfo@madisonsfoundation.org
    Home page: http://www.madisonsfoundation.org
  • Trimethylaminuria Foundation
    P.O. Box 3361
    Grand Central Station
    New York NY 10163-3361
    Phone #: 212-300-4168
    800 #: --
    e-mail: theTFnetwk@aol.com
    Home page: N/A
  • Trimethylaminuria Midwest Region Foundation
    12537 Hardy Street
    Overland Park KS 66213-1446
    Phone #: 913-906-9496
    800 #: --
    e-mail: EMPORIA962000@YAHOO.COM
    Home page: N/A

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Last modified Wednesday, November 26, 2008