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The complex metabolism of trimethylamine in humans: endogenous and exogenous sources

Published online by Cambridge University Press:  29 April 2016

Jyoti Chhibber-Goel
Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
Anamika Gaur
Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
Varsha Singhal
Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
Neeraj Parakh
Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India
Balram Bhargava
Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India
Amit Sharma
Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
E-mail address:


Trimethylamine (TMA) is a tertiary amine with a characteristic fishy odour. It is synthesised from dietary constituents, including choline, L-carnitine, betaine and lecithin by the action of microbial enzymes during both healthy and diseased conditions in humans. Trimethylaminuria (TMAU) is a disease typified by its association with the characteristic fishy odour because of decreased TMA metabolism and excessive TMA excretion. Besides TMAU, a number of other diseases are associated with abnormal levels of TMA, including renal disorders, cancer, obesity, diabetes, cardiovascular diseases and neuropsychiatric disorders. Aside from its role in pathobiology, TMA is a precursor of trimethylamine-N-oxide that has been associated with an increased risk of athero-thrombogenesis. Additionally, TMA is a major air pollutant originating from vehicular exhaust, food waste and animal husbandry industry. The adverse effects of TMA need to be monitored given its ubiquitous presence in air and easy absorption through human skin. In this review, we highlight multifaceted attributes of TMA with an emphasis on its physiological, pathological and environmental impacts. We propose a clinical surveillance of human TMA levels that can fully assess its role as a potential marker of microbial dysbiosis-based diseases.

Copyright © Cambridge University Press 2016 

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