Medical Definition of Trimethylaminuria (TMA)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Trimethylaminuria (TMA): An inborn error of metabolism associated with an offensive body odor, the smell of rotting fish, due to the excessive excretion of TMA in urine, sweat, and breath. Persons with TMA may experience tachycardia (fast heart rate) and severe hypertension (high blood pressure) after eating cheese (which contains tyramine) and after using nasal sprays containing epinephrine. TMA is caused by a mutation (change) in the gene for an enzyme, flavin-containing monooxygenase-3 (FMO3) encoded by a gene on chromosome #1. The FMO3 enzyme metabolizes tyramine (which is in cheese). The syndrome is associated with various psychosocial reactions, including social isolation, clinical depression and attempted suicide.

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Reviewed on 12/27/2018

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