RT Journal Article
SR Electronic
T1 Fish odour syndrome
JF Postgraduate Medical Journal
JO Postgrad Med J
FD The Fellowship of Postgraduate Medicine
SP 451
OP 452
DO 10.1136/pgmj.75.886.451
VO 75
IS 886
A1 H U Rehman
YR 1999
UL http://pmj.bmj.com/content/75/886/451.abstract
AB Fish odour syndrome (trimethylaminuria) is a metabolic syndrome caused by abnormal excretion of trimethylamine in the breath, urine, sweat, saliva and vaginal secretions. Trimethylamine is derived from the intestinal bacterial degradation of foods rich in choline and carnitine and is normally oxidised by the liver to odourless trimethylamine N-oxide which is then excreted in the urine. Impaired oxidation of trimethylamine is thought to be the cause of the fish odour syndrome and is responsible for the smell of rotting fish. Certain foods rich in choline exacerbate the condition and the patients have a variety of psychological problems. Recognition of the condition is important as dietary adjustments reduce the excretion of trimethylamine and may reduce the odour. Occasionally, a short course of metronidazole, neomycin and lactulose may suppress production of trimethylamine by reducing the activity of gut microflora.