If you think you may have trimethylaminuria (TMAU), please read this description of TMAU.
We now offer diagnostic testing for TMAU through the Biochemical Genetics Laboratory at the University of Colorado. We have decided that all testing will be coordinated through Monell so that the protocol using the Choline Challenge Test, developed over the past 25-plus years, remains consistent.
For information on how to be tested for TMAU, please use the Contact Us page to submit your question and include as much detail as possible about the nature of your disorder and its history. Although, we do not require a physician’s referral for testing, we do suggest that you discuss your situation with either your primary care doctor or an appropriate clinical specialist.
Our diagnosis of body odor problems currently is limited to TMAU. Please note that we are unable to assess the nature or strength of your odor-production problem. We also cannot advise patients on body odor problems if you do not have a specific diagnosis or the results of clinical tests. Dr. Preti is a full-time research scientist who has a PHD in organic chemistry. He is not a physician or dentist and does not treat patients.
Please do not send queries regarding clinically undiagnosed body odor problems, as Dr. Preti and other Monell scientists are not clinicians and will be unable to respond.
If your results indicate a diagnosis of TMAU, we may be able to make recommendations for odor reduction and amelioration.
This diagnostic service is not currently supported by public or private funding, so there is a cost to cover a portion of the expenses. We cannot accept insurance or do third party billing.
Please be patient while waiting for a response. Although we realize that it may be frustrating to wait, please do not contact us repeatedly, as that will take time away from our work efforts. Dr. Preti answers all of these inquiries personally, and he often receives dozens of emails each week. However, if you do not hear from us after a reasonable period (3 months) or if your information changes, please contact us again.
Please do not call Monell’s main number or the Monell-Jefferson Taste and Smell Clinic, as they will not be able to help you with malodor problems.
In our experience, the most common cause for undiagnosed malodor production is the genetically-inherited, odor-producing disorder trimethylaminuria (TMAU). Click here for a description of TMAU.
Bad breath (Halitosis; Chronic halitosis )
More than half of the individuals we see report oral symptoms, with most complaining of halitosis. Halitosis and TMAU are two different conditions that may occur together; someone with bad breath may or may not also have TMAU. Chronic halitosis can be falsely interpreted as a body odor because the odor is projected around your body each time you exhale or speak. Many patients who think they have TMAU are in fact suffering from chronic halitosis.
Chronic halitosis originates on the rear, top-part of the tongue surface where a bacterial plaque can develop. Why some people develop this and some do not is not exactly known. This plaque is similar to the plaque on teeth and gums, but is caused by a different group of bacteria.
Chronic halitosis can exist without the presence of gum or periodontal disease; persistent oral odor is unlikely to come from your teeth and gums (so cleaning them doesn’t help this situation) or digestive tract. Most dentists and physicians are unaware that chronic bad breath is an oral, tongue-derived situation.
Chronic bad breath may smell like foul garbage and sometimes like a bowel movement/fecal-matter or like “something died.” Further, if you are stressed, this will tend to dry the mouth making the odors produced in the plaque more airborne due to lower salivary flow. Halitosis may be a life-long problem, since we have seen children as young as 12-13 years old with this problem.
Because of the underarm ecology and chemistry, certain types of odors are produced there which are perceived as “sweaty, sour or musty.” Modern deodorant and antiperspirant products are designed to reduce male and female underarm odors for 12-24 hours.
We have seen less than a half-dozen individuals with strong underarm odors (out of more than 320 patients seen), confirmed by us at social distances. These individuals are generally referred to a dermatologist for treatment. Your underarms are unlikely to produce the odor caused by TMAU.