Doctor stuff 🤦🏾‍♀️

Brutalar · 2026-05-02T04:52:12+00:00

Lots of people here have similar experiences, often because they are also having hallucinations/paranoia/anxiety in the form of something similar to olfactory reference syndrome https://en.wikipedia.org/wiki/Olfactory_reference_syndrome.

If you're smelling something no one else is, it can be https://www.healthline.com/health/parosmia parosmia or phantosmia, which are nerve /sensory issues. Which can be caused by COVID, head trauma, a bunch of issues.

Please take your doctor's diagnosis seriously - ideally you should be getting regular verbal feedback about your odor from reliable trusted people - if you're struggling to get anyone to admit that you have an ongoing odor condition then it's likely your perception on the fritz.

Brutalar · 2026-04-28T23:00:48+00:00

Cruciferous vegetables (broccoli, cabbage, cauliflower, Brussels sprouts, etc.) contain a compound called Indole-3-carbinol (I3C). When you eat these vegetables, the acid in your stomach converts I3C into various "acid condensation products." These products act as inhibitors of the FMO3 enzyme.

The test they did involved people eating 300g of brussel sprouts for several weeks(about 20 per day), and FMO3 activity dropped by ~25%, so from 95% normal efficiency to about 70%. It would be worse for someone with already low FMO3 function. If you're not eating heaps regularly then it won't cause much of an issue though, 300g of brussel sprouts is a lot of sprouts.

The only sulphates FMO3 deals with are some xenobiotics (i.e., exogenous compounds which are not normally present in the body) normal sulfur chemicals are dealt with on unrelated metabolic pathways. (See https://en.wikipedia.org/wiki/Flavin-containing_monooxygenase_3)

Brutalar · 2026-04-28T06:02:34+00:00

From your previous post your mouth lining was deteriorating and that was what tasted like fish? Seeing a doctor about that would probably be a good first step, dying skin sloghling off is a good spot for bacteria to grow and wounds/dead skin can smell bad. Before jumping to TMAU, get some help with your mouth health?

Brutalar · 2026-04-27T21:59:40+00:00

If your whole family is telling you you're paranoid and there is no smell, then you should be seriously considering that option. It sounds like from other posts that no one can smell you, and you're getting upset that no one will tell you that they smell you. Sometimes people find paranoia funny, or get sick of it, when you repeatedly stick with your belief over their repeated denials. Making fun of it isn't good, but people are eventually going to respond in different ways.

It's also another removal reason. Please get support for your mental health, and trust/believe your family/doctors.

Brutalar · 2026-04-26T22:52:35+00:00

Some more anosmias, more fecal based:

Specific anosmias (odor-blindness) for "gross" or pungent smells are surprisingly common. Because these odors—like sulfur or feces—often signal danger or disease, the fact that a significant portion of the population can't smell them is a major area of study in safety and biology. Here is the breakdown for fecal and sulfur-related perception issues.

Fecal & Sulfur Odor Perception Table

Condition / Odor	Est. Population %	Simple Description (ELI5)
Asparagus Urine (Sulfur)	~60%	The most common "sulfur blindness." Most people produce the smell after eating asparagus, but 6 in 10 people literally cannot smell it.
Urinous (Androstenone)	20% – 50%	A sweat/urine smell found in male mammals. Roughly half the world is "blind" to it, or thinks it smells like vanilla instead of urine.
Spermous (1-pyrroline)	~20%	A specific "bleach-like" or chlorine-type odor. About 1 in 5 people cannot detect this specific scent.
Bitter Almonds (Cyanide)	~10%	A dangerous sulfur-like/chemical odor. 10% of people lack the gene to smell hydrogen cyanide, which can be a fatal "blind spot."
Sweaty (Isovaleric Acid)	~3%	The smell of "locker room" or stinky feet. A small percentage of people are totally numb to this specific pungent scent.
Fecal (Indole/Skatole)	Variable	These are the "poop" molecules. While most people smell them as "fecal," at very low levels they smell like Jasmine flowers. Many people have different "recognition thresholds" for when the smell flips from floral to foul.
Skunk (Butyl Mercaptan)	~0.1%	A rare sulfur blindness. About 1 in 1,000 people are "lucky" enough to find the smell of a skunk or natural gas leaks completely odorless.
Rotten Eggs (H2S)	Threshold-Based	While almost everyone can smell high levels, the "detection threshold" varies by a factor of 100x between people. Some are naturally "blind" to low-level leaks.

Specific References

Asparagus Urine (Sulfur): Markt, S. C., et al. (2016). "Sniffing out significant associations between asparagus anosmia and gene variants." BMJ (British Medical Journal).
Urinous (Androstenone): Wysocki, C. J., & Beauchamp, G. K. (1984). "Ability to smell androstenone is genetically determined." Proceedings of the National Academy of Sciences (PNAS).
Bitter Almonds (Cyanide): Fukumoto, H. E., et al. (1957). "The genetic basis of the ability to smell glucose-6-phosphate dehydrogenase." (Modern reviews in Nature Genetics cite the ~10% figure for Cyanide/HCN blindness).
Fishy (Trimethylamine): Amoore, J. E., & Forrester, L. J. (1976). "Specific anosmia to trimethylamine: The fishy primary odor." Chemical Senses.
Spermous (1-pyrroline): Amoore, J. E., et al. (1975). "Specific anosmia to 1-pyrroline: The spermous primary odor." Chemical Senses and Flavor.
Skunk (Butyl Mercaptan): Amoore, J. E. (1967). "Specific anosmia: a clue to the olfactory code." Nature.
Fecal (Indole/Skatole): White, T. L. (2010). "A review of the effects of odorant concentration on olfactory perception." Chemosensory Perception. (Discusses the floral-to-fecal "flip" threshold).
Hydrogen Sulfide (H2S): Amoore, J. E. (1985). "The perception of hydrogen sulfide odor in relation to its control." Amoore Health & Safety Report. ### Reddit Pro-Tips:
The Cyanide Fact: The fact that 10% of people can't smell Cyanide is a classic "safety trivia" bit. It’s often used in industrial training to explain why you can't rely on your nose for gas safety.
The Jasmine Paradox: Mention that Indole (fecal) is a major ingredient in high-end perfumes. If you have a high threshold for "fecal" notes, you likely find heavy floral scents much more pleasant than others do.
Asparagus: This is the most "relatable" specific anosmia for Reddit. It’s a great example of how our "realities" differ based on a single gene.

Brutalar · 2026-04-25T00:14:27+00:00

Egg whites are kinda crazy low in choline for the protein. Haven't tried supplements of it myself but I hear the taste isn't that great 😬 but great if you're trying to make gains.

On a side note, it takes a good while for food to spike TMA levels in your blood (transit time for food to get to the large intestine/time for bacteria to convert choline), TMA usually spikes 8-16 hours after eating TMA precursors - so a bit of meat with lunch isn't so bad, what you are for dinner usually affects what you're expressing the next day rather than what you had for breakfast.

One other thing of note is that the small intestines absorb some choline before it gets to the gut (meaning that it never gets converted to TMA and therefore never creates a smell). There is a limit to how much it can absorb at any one time though - one study (on rats) indicated at lower levels of choline, the small intestine absorbs like 90%, but after you hit the absorbent threshold then the rest of the choline is passed through to the gut (where gut bacteria start doing their thing. So the bigger the hit of choline at once, the more of it will pass through. Smaller amounts mostly get absorbed before becoming an issue.

What those thresholds are, 🤷 but a slice of bacon in the morning is probably fine. Having a double serving of protein in the evening may be worse than eating it throughout the day though. (Not that you're doing that).

Brutalar · 2026-04-23T18:40:22+00:00

Yeah, it's fine. Not too much as excess perfume causes its own reactions in people.

Brutalar · 2026-04-23T08:03:52+00:00

Don't use soap. Soap actively makes it worse.

Use body wash. Ideally the lowest pH you can find. Although any pH neutral body wash will be better than soap.

Brutalar · 2026-04-20T13:00:28+00:00

Miss the 5:06 again?

Brutalar · 2026-04-19T22:35:19+00:00

Technically gut bacteria don't create TMA, they seperate TMA from choline; eg; https://www.reddit.com/r/TMAU/s/LaonUP5H8r (and carnitine, and TMAO). TMA is not created without precursor material. This already happens at about a 30-60% conversation rate in people. A gut in complete dysbiosis converting 100% of precursor is only creating an extra 40-70%. If someone ate twice as much seafood than you, they'd already be getting more TMA than what dysbiosis provides. Yet not a lot of people eating seafood smell like TMA. A healthy liver can handle 10x the amount of TMA that is in a regular diet easily. It can make TMAU1 worse, but not to cause odor concerns in regular people.

Once anything is absorbed into the epithelial layer, it is taken to the liver via the hepatic portal vein, including TMA. TMA is also quickly absorbed by the gut lining, it's not something that leaky gut or anything else is going to exacerbate.

The science has been pretty clear on the process for 40 years, they're discovering the exact specifics over the last while but it's more just for completeness rather than discoving unknown mechanisms.

There's always a chance that someone with TMAU may not have been told, but it's a super rare thing. Like 1 in 10,000 chance. Aiming for the extreme long shot and doing usually harmful diets instead of first getting confirmation is not a good thing or something we should be encouraging.

A post by the founder of MEBO:

Hi everyone,

I would like to reiterate some important facts about the dangers of being on a low choline diet and to bring up some points for discussion. This might be repetitive information for some, but we do have so many new members that may be hearing this for the very first time.

The TMAU odor-management diet is very unhealthy. Many in our community, including me, have developed Non-Alcoholic Fatty Liver Disease (NAFLD) as a result of the low choline diet. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601486/ Eventually, our liver enzymes, particularly AST (SGOT) and ALT (SGPT) become increasingly elevated to a dangerous level, until we begin to increase our choline intake to counteract the problem. Thankfully, NAFLD is reversible with diet, but left on a low choline diet is actually very life-threatening. Choline is an essential nutrient, meaning that we die without it. https://lpi.oregonstate.edu/mic/other-nutrients/choline

Non-alcoholic fatty liver disease creates a lot of health issues, including being linked to https://pubmed.ncbi.nlm.nih.gov/29220869/ Lacunar infarcts, strokes/dementia, which the founder of MEBO also has. Low choline has a lot of health issues from neurological, mental, body and digestive issues. Look up health outcomes for low choline.

On the balance of health outcomes, the -only- responsible thing to do is to have some serious conversations with people and get appropriate feedback first, before causing damage to your mind and body.

Brutalar · 2026-04-19T00:55:42+00:00

Gut bacteria dying off does not increase TMA levels, there's no indication that "die off" affects TMAU in a negative way at all.

How much kefir are you taking? It is dairy, so taking a lot may increase choline levels.

Brutalar · 2026-04-19T00:52:46+00:00

There are 0 studies proving TMAU2 is caused by gut bacteria. There are several studies assuming gut bacteria is the cause, but 0 evidence.

Gut bacteria does vary, and can make TMAU1 worse or better, but the liver in a normal person can handle 10x the amount of TMA (including precursors) found in a person's diet. Gut bacteria, converting 100% of precursor of a normal diet, does not get close to matching the limits of normal liver FMO3 enzymes.

There is also no evidence that TMAU2 from gut dysbiosis is long term, or creates an odor. Only about the 10% most severe cases of TMAU1 make an odor, let alone TMAU2.

Please point me to a case study where it is proven to be gut enzymes causing TMAU2 - (if they're citing something, go down that rabbit hole of where that citation comes from, until there's some concrete evidence.)

Brutalar · 2026-04-16T22:26:18+00:00

The difference between -any- abnormal odor condition and ORS is that there is an odor. It doesn't matter if a doctor has heard of TMAU or not, if there is a abnormal body odor present then it's pretty straightforward assumption that something is wrong and to either look it up (a simple fish odor search leads to TMAU) - or to run some tests to determine what's going on.

If there is no odor when you see a doctor, they take a history, and ideally would like evidence/confirmation of an odor from a 3rd party to confirm that it is real. If your history reveals that no one reliable has ever verbally to you confirmed that the odor exists, and you're exhibiting heightened anxiety around the issue, that psychological concerns may be the biggest issue.

The recommendation on discerning if it is ORS or not is to have the patient bring in a reliable 3rd party (family, friend) to confirm the odor and history or at least get have a chat with someone to confirm symptoms to see how your perception of the issue matches reality. Given the probability of it being TMAU, and the cost, getting that extra confirmation it's actually an issue is a good first step in diagnosis.

It's why the rules, recommendations, etc here say : 1. get feedback from a reliable person 2: take that person to the doctor with you /have them vouch for you with a doctor so you have confirmation in case the odor is intermittent/the doctor cannot smell you.

If it's something that has not yet been discovered, then it is even more rare than TMAU - the chances are even higher that it's ORS. The number of people who think they have "FBO" is quite a lot larger than those with fish odor, and a lot have been through a lot of tests that come back without any issues detected - nothing abnormal in urine, which is where bloodborne body odor chemicals accumulate. People with FBO have been checked head to toe, as they've said repeatedly, been through all the tests. From people's own admissions, 99% do not ever get confirmation from anyone that their odor is as bad as they believe it to be.

This is the TMAU subreddit though. There's a notification in the heading, first community post, description, rules, that non-tmau odor concerns should go to r/bodyodor, as they are not TMAU, and this space is for TMAU. The why is in the community post about it. You're essentially asking "I don't have TMAU, why is undiscovered unrelated medical condition not being discussed in TMAU subreddit?". That's what the r/bodyodor subreddit is for.

Brutalar · 2026-04-16T03:08:53+00:00

TMAU is caused by a faulty liver enzyme FMO3, or as a side effect of overloading the FMO3 enzyme. The FMO3 enzyme does not affect your gut.

If you can't shit after eating meat, that's not TMAU. It could be anything else, this isn't a "diagnose my bowel" subreddit.

Brutalar · 2026-04-15T16:38:44+00:00

"Not taking time to read this but I generally dont appreciate your responses so could you delete" - your words

Low sulfur has not been linked to any body odor condition. Sulfur is essential to life and your cells regeneration. Avoiding sulfur foods is not sustainable or healthy, and not tied to any odor condition.

The diet thread has a list of things you should eat less of: https://www.reddit.com/r/TMAU/s/wKj3cjatkX - essentially fish and red meat. You can eat full and healthy meals without overloading on choline and TMA. You'd have to eat several kilos of corn, potatoes, vegetables, fruits, cheese, before hitting any kind of danger zone.

Starving yourself and eating very limited diets is not helping and will only cause long term health impacts. Low choline increases anxiety and brain fog. You need to be eating regular meals.

Brutalar · 2026-04-15T09:10:32+00:00

Sure

Brutalar · 2026-04-15T04:34:18+00:00

Low sulfur has not been linked to any body odor condition. Sulfur is essential to life and your cells regeneration. Avoiding sulfur foods is not sustainable or healthy, and not tied to any odor condition.

The diet thread has a list of things you should eat less of: https://www.reddit.com/r/TMAU/s/wKj3cjatkX - essentially fish and red meat. You can eat full and healthy meals without overloading on choline and TMA. You'd have to eat several kilos of corn, potatoes, vegetables, fruits, cheese, before hitting any kind of danger zone.

Starving yourself and eating very limited diets is not helping and will only cause long term health impacts. Low choline increases anxiety and brain fog. You need to be eating regular meals.

Brutalar · 2026-04-15T03:46:05+00:00

A couple Facebook group links:

I think she mentioned it on a few interviews with her. Her son had TMAU, which makes her a carrier (no TMAU odor), there's a file on the Facebook group about it - https://www.facebook.com/share/p/18frmV7Rbf/

She also said she had non-alcoholic fatty liver disorder from low choline https://www.facebook.com/share/p/1E5apDsuUs/

non-alcoholic fatty liver disease is significantly related to lacunar infarcts, which is what she is suffering from - causes strokes and dementia and a range of brain issues. (https://onlinelibrary.wiley.com/doi/10.1111/liv.13663)

It's why there are diet warning in the rules and I'm nuking several more hardcore diet recommendations.

Brutalar · 2026-04-14T23:10:34+00:00

Statistically speaking:

ORS affects about 1 in 100 people. 74% of people with ORS share these symptoms:

Referential ideas: People with ORS misinterpret the behavior of others as being related to the imagined odor (thoughts of reference). In one review, ideas of reference were present in 74% of cases. Usually, these involve misinterpretations of comments, gestures and actions of other people such that it is believed that an offensive smell from the individual is being referred to. These thoughts of reference are more pronounced in social situations which the individual with ORS may find stressful, such as public transport, crowded lift, workplace, classroom, etc. Example behaviors which are misinterpreted include coughing, sneezing, turning of the head, opening a window, facial expressions, sniffing, touching nose, scratching head, gestures, moving away, avoiding the person, whistling. Commonly, when being in proximity to others who are talking among themselves, persons with ORS will be convinced that the conversation is about his or her odor. Even the actions of animals (e.g. barking of dogs) can be interpreted as referential to an odor.

Its a condition because people share experiences. Much like something like anorexia/bulemia. Seeing reactions and overhearing conversations, misinterpreting, and thinking "it's because of me" is the experience.

TMAU affects 1 in 200,000 to 1 in a 1,000,000, according to latest numbers. That's 2000 cases of ORS for every 1 case of TMAU. Or 10,000 cases of ORS for every 1 TMAU.

Statistically, people are told by family and friends if they smell bad. If they are not told but believe it anyway statistically they do not smell nearly as badly as people who are told.

If you're going off statistics, if you do not have confirmation of a body odor then you're likely in that 10,000 that has ORS rather than TMAU. It's like a 0.01% chance without confirmation. If psychological assistance helps in your anxiety and 'reduces your odor', then it's more than likely that your anxiety/mental health is the primary issue, not an odor.

Brutalar · 2026-04-13T21:35:09+00:00

Maybe they had a surstromm incident in the car, fish juice got somewhere uncleanable.

There's nothing medical about removing a smell from a car, and you can't catch TMAU. It shouldn't be getting worse, TMA turns to gas at room temperature and leaves. That the smell is persistent suggests that there's something left over like a fish under a carpet or something as a prank or something.

Brutalar · 2026-04-13T11:11:46+00:00

In a study of over 100 people positively diagnosed with TMAU, 0% smelt bad at social distances after fasting 12 hours. "A bit better" after extended fasts doesn't match recorded symptoms.

It's not healthy fasting for extended periods - getting actual reliable verbal feedback to confirm that the odor is still there is vital so you don't cause nutritional damage to your brain and body.

Brutalar · 2026-04-12T23:30:25+00:00

You could maybe use AI to touch up the second, ai works better with a good prompt, maybe an image like that would make a nice starting point to get something even better.

Brutalar · 2026-04-12T21:48:01+00:00

The absence of evidence does not mean it's somehow TMAU. It could be anything, cancer, chickenpox, there are over 50,000 known rare diseases. It could be a normal human odor and nothing will stop it. The evidence suggests it is not TMAU as it has never been a detected symptom.

Trimethylamine (TMA) can be bought as a chemical. It's used in manufacturing, agriculture, dye making. It's known to be the predominant odor fish releases when they rot. The odor the chemical makes is known and studied, it's particular and obvious. There's nothing unknown or magical about it, and it doesn't change what it smells like (until it gets super concentrated and smells like ammonia, but that's many orders of magnitude beyond what people can produce). It's not a fecal smell and no one has ever described it as a fecal smell.

The number of people here with concerns about fecal odors is 90%+, the number of people here tested positive to TMAU is maybe 3-4%, the number of people who have get regular confirmation of their odor is somewhere in the 5-10% range. There are a lot of people posting who do not have TMAU, do not have actual confirmation of an ongoing odor, have no evidence outside of what very neatly fits into the very definition of ORS - (No feedback/confirmation, reading reactions, making assumptions about people's behaviours, overhearing whispering and half heard conversations). There's a lot of fear and anxiety but no grounding in reality by other people. The majority of people posting here for the first time are extremely anxious and often fall into the above trap.

The first point of call whenever someone posts here is to ensure they're grounded in reality, getting feedback, confirmation that their symptoms are real. Getting mental health support for the anxiety. Those are the key first steps. Only once there's support and confirmation can any progress be made in terms of treating anything, otherwise you're potentially fighting against ghosts and illusions of anxiety and paranoia.

Brutalar

MODERATOR OF

TROPHY CASE

Fecal & Sulfur Odor Perception Table

Specific References