The rare disease that makes your body smell like garbage or fish

Trimethylaminuria, also known as ‘fish odor syndrome’, is caused by a failure in the production of the enzyme flavinmooxygenase (FMO3). This enzyme is responsible for breaking down trimethylamine (TMA), which can otherwise only be eliminated through perspiration, urine or breath.

• READ ALSO: Extreme heat on summer nights can increase deaths in men

The lack of this enzyme causes people to acquire a very strong smell of sulfur or ammonia, commonly described as the smell of garbage.

The first symptoms of this condition usually appear in childhood and, although they have no effect on growth or psychomotor development, they can have serious social repercussions on children. It is common for patients to develop low self-esteem, anxiety and/or depression.

• READ ALSO: Fourth dose of covid vaccine reduces mortality by 78%, according to Israeli study

The diagnosis of this disease occurs through two steps: a urine test that confirms the excess of TMA and a study of the molecular genotype that identifies the associated mutation.

Although there are patients who are born with the syndrome, there are also cases of acquired trimethylaminuria. This is what happened to Ellie James, a woman who at the age of 14 had to go through a long process with antibiotics that ended up affecting her FMO3 production.

It took James a long time to realize his condition, because for many months he believed that it was just a hygiene issue. “At first it’s very difficult to go to the doctor because you’re really not sure if you have something wrong,” she told the ‘BBC’ agency in 2014.

Before she was diagnosed, James was constantly cleaning herself with disinfectant and her co-workers used to give her special soaps and deodorants. Still, this failed to hide a pungent odor that even led to her being verbally attacked on public transport.

The life of patients can be easier after a diagnosis, because although the syndrome of fish odor there is no cure, it does have a dietary treatment which consists in reducing the consumption of foods high in choline such as eggs, organ meats, lean meats and fast foods.

However, the treatment is not perfect, because long-term choline restriction can cause liver and neurological damage and could even increase the predisposition to cancer, according to specialized portals.

It is a slow and constant process for patients who suffer the social consequences of their condition, but there are those who learn to live with it.

“I don’t blame anyone for the reaction they had with me”, James confessed to ‘BBC’. “This is a very rare disorder and they act out of ignorance.”

Weather, Colombia/GDA