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[DOI] [PubMed] [Google Scholar] 42.Olpin SE, Afifi A, Clark S, et al

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Mutations in FMO3 can prevent TMA from being converted into TMAO, with excessive TMA excreted through urine, sweat, and breathing, emitting a fishy smell, which is clinically called fishy smell syndrome ( TMAO's Impact on AS In recent years, TMAO has been found to be associated with heart failure ( Controversially, a study on Apoe / mice revealed that choline supplementation promotes increased TMAO levels (increase to 20 M on chow diet and 9 M on Western diet) in CONV-R mice but does not affect aortic lesion size, whether on chow or HFD ( / mice and HFD-fed CONV-R Ldlr / mice ( Some clinical studies have also suggested that TMAO has a positive role in atherosclerotic disease

They will also likely look at underlying (and common thyroid) issues, such as nutrient depletion and absorption issues that a conventional medicine doctor might not look at, and whether you have the MTHFR gene variation (which can impair thyroid hormone levels and energy metabolism)
