How to Reduce Your TMAO Levels

How to Reduce Your TMAO Levels

[Music] eating choline and carnitine rich foods meat eggs and dairy can be converted by gut flora into trimethylamine which can then be turned into TMAO and our liver a toxic compound which may increase our risk of heart failure kidney failure and atherosclerosis heart attacks and strokes the good news is though that this opens up exciting new nutritional and interventional prospects for prevention okay so how are we going to do it if our gut bacteria can take meat dairy and eggs and turn it into TMAO all we have to do is destroy our gut flora we could give people antibiotics to eliminate the production of TMAO however that could also kill our good bacteria and facilitate the emergence of antibiotic resistant strains hmm how about probiotic supplements maybe if we add good bacteria it will crowd out the ones that take the meat egg and dairy compounds and turned into TMA which our liver turns into TMAO but it doesn’t work and in good bacteria doesn’t seem to get rid of the bad what if we added a new bacteria that could somehow siphon off the TMA made by the bad bacteria well there’s a bacteria inside the guts of cows and sheep that turns trimethylamine into methane so maybe we could use the bacteria to get rid of some that from our gut like like a cow fecal transplant the problem is if it didn’t take you’d have to keep giving it to people so maybe the fact that Consumer Reports found fecal contamination in every sample of beef they tested may be a good thing No methane producing bacteria may be able to eat up our TMAO but unfortunately these bacteria may be so associated with a variety of diseases from gum disease down to colorectal cancer so if antibiotics and probiotics aren’t going to work to prevent gut bacteria from taking meat dairy and eggs and turning them into trimethylamine which our liver makes TMAO out of I guess we have no choice but to cut down on our liver function that was the billion-dollar answer to cholesterol these same foods raise our cholesterol but dietary change isn’t very profitable so the drug industry came up with statin drugs that cripple the livers enzyme that makes cholesterol so a pharmacologic inhibition of the enzymes in our liver that make TMAO could potentially serve as a therapy for cardiovascular disease risk reduction but there’s a genetic condition in which this enzyme is naturally impaired called trimethylamine urea on which there’s a buildup of trimethylamine in the bloodstream the problem is that trimethylamine is so stinky it makes you smell like dead fish so given the known adverse effects from sufferers of this fish odor syndrome the untoward odorous side effects make it a less attractive drug target so do we have to choose between smelling like dead fish or suffering from heart and kidney disease if only there was some other way we could somehow stop this process from happening well what do those with trimethylamine urea often do to cut down trimethylamine levels they stop eating animal products about a third of those who complain of really bad Bo despite good personal hygiene test positive for the condition but reducing or eliminating meat egg and dairy intake can be a real lifesaver but given what we now know about how toxic the end product TMAO can be for normal cutting down on animal products may not just save the social lives of people with a rare genetic disorder but help save everyone else’s actual lives the simplest point of intervention is to just limit the consumption of foods rich in choline and l-carnitine which can be an effective strategy to limit circulating TMAO but wait we could always try to genetically engineer bacteria that eats up trimethylamine but the simplest safest recommendation may just be to eat healthier you can completely eliminate carnitine from the diet since their body makes all we need but choline is an essential nutrient so we need some and we can get all we need in fruits vegetables beans and nuts however excess choline such as that found in eggs may be worth avoiding need we worry about high coaling plant foods like broccoli cruciferous vegetable consumption is associated with a significantly longer life less cardiovascular disease mortality to see what was going on researchers took the vegetable highest in choline brussel sprout and had people eat two cups a day for three weeks and their TMAO levels actually went down it turns out that Brussels sprouts appear to down regulate that TMAO liver enzyme naturally not enough to make you stinky but just enough to drop TMAO and people who eat completely plant-based may not make any TMAO at all even if you try you can give a vegan a steak which contains Colleen and carnitine and not even a bump in TMAO since vegetarians vegans have different gut microbial communities if we don’t eat steak then we don’t foster the growth of steak eating bacteria in our gut so hey forget the cow how about getting a fecal transplant from a vegan from a TMAO standpoint maybe we don’t have to eat like a vegan as long as we pou plike on [Music] you

100 thoughts on “How to Reduce Your TMAO Levels

  1. We need more videos on poop. I eat so much bulk and my body likes to get rid of. We need poop pictures with food intake listed, to make sense of it all–for science!

  2. This video shows how we are such a society of creating problems, that we don't need to have, and then trying to solve them with some kind of band-aid solution instead of solving the problem at the root. It's disheartening and it's hard to have a positive outlook for the human race as a result of this. We think and act in this way for everything in life it seems.

  3. Fuck this, I just want to know the correlation between nutritional yeast, Crohn's Disease and supposedly inexistent condition called Candidiasis. Are those series over?

  4. “One lady with psoriasis all over the body was under allopathic treatment for over one and a half years. She happened to prepare panchagavya for field use and stir the contents with her forearm. After 15 days, the psoriasis in her forearm got fully cured. Following her own intuition, she smeared panchagavya all over the body and to everyone’s surprise the psoriasis disappeared in 21 days,” the Tamil Nadu Agricultural University (TNAU) website claims.

    Saw this in a south indian website. Surprise surprise, that pachagavya or watever is made from cow dung and urine and three other stuff. LOL.

  5. Stop eating animal products? No, that's way too insanely radical! 🙂 Please keep looking for a pill I can take that will fix everything. There's gotta be one.

  6. i <3 this microbiota-videos!!! Dankeschön! Nachdem ich erahnt habe, wie wichtig meine guten Jungs im Darm für mich und meine Gesundheit sind und was sie brauchen, füttere ich sie ordentlich und entziehe den schlechten Jungs das Essen. Für mich im Moment die allerallergrößte Motivation pflanzenbasiert vollwertig zu essen! Ich kann mich gar nicht genug für diese wichtigen Infos bedanken! Nicht nur der Tod, auch die Gesundheit liegt im Darm! Empfehlenswert auch von Armando Hasodungan die "hungry microbiome"-Reihe:

  7. I try to explain this stuff to my relatives, but they think I'm just brainwashed by "scientists." Seriously, can't even make this stuff up…

  8. Love the studies trying to show adverse side effects of eating 'high' doses of fruits or vegetables ONLY to show good effects! 🙂

  9. I sat here clapping at the points about gut health like a little kid, and that vegans don't produce any TMAO at all. For the last three years I've researched like a man possessed about gut flora and it's interaction with psoriasis, and how diet and stress affect zonulin, which is the chemical key to leaky gut.
    Without a medical degree it's tough to be certain, but I am 90% so in that gut health is the key to not only autoimmune issues, but also is directly connected to psyche issues like depression through the gut-microbiome-brain axis.
    Thanks Doc Greger for bringing some of us closer to the reality of the world around us.

  10. Hi !
    What about the gym goers that consume L-carnitine to "burn more fat" when they exercise?
    That kind of supplements can be converted by our gut microbiota to TMA too?

  11. Man I wish it wasn't such a hard change to veganism. I think it would be easier without little kids of 4 and 7, but I'm not giving up!

  12. Do vegans or vegetarians( that don't consume dairy ) need to take any vitamins or supplements like Omega 3, vitamin b12 or iron?

  13. Based on the info at the end of the video, it appears that all we need is a probiotic that mimics the microbiota of a vegan, then we can still eat our steak. We were designed by nature to be ominores, not vegans, it's not even disputable in science. jury's in.

  14. God, people are dumber than rocks. First it was saturated fat and cholesterol. Oh no, not that? It must be carnitine! Yup. Yup, that's why meat is bad. Cuuzz uh TMAO. You're going to believe the next explanation too when quality science dismantles this one, aren't you?

  15. Hmmm.. I'm starting to hear their cry. They are going from "my food poops on your food" to "your poop can save me from my food"

  16. Why don't your provide all the research?

    TMAO REDUCES aortic lesions in mice:

    Intake of up to 3 Eggs/Day Increases HDL Cholesterol and Plasma Choline While Plasma Trimethylamine-N-oxide is UNCHANGED in a Healthy Population:

    Oral L-carnitine supplementation increases trimethylamine-N-oxide but reduces markers of vascular injury in hemodialysis patients.

    Propionyl-L-carnitine prevents the progression of atherosclerotic lesions in aged hyperlipemic rabbits.

    The verdict on carnitine and TMAO is far from settled.

  17. You kind of need choline for brain health, bit of a catch 22. You have a lot of great info when it comes to plant based nutrition within the context of benefits from consumption of various plant based foods, like brussel sprouts in this video, but in recent years, studies on ketogenic diet in terms of insulin health and autophagy, lifespan, etc, are contradicting you quite a lot. I don't think you've made a very good case against fats or animal products, but you've made a good case for getting more greens, berries and legumes.

  18. A little tmao isn't really that big of a deal. It's not a black and shite scenerio like you suppose. It's not either eat meat and dairy and have heart disease or don't. LOL, this channel cherry picks the studies to cloak their biases in scientific research. It's a bullshit channel and disingenuous.

  19. This channel is awash with ideologically driven content. Pescatarians live longer than vegans and vegetarians; however, fish have a significant amount of TMAO and TMA, hence the fishy odor that they contain. Moreover, vegetarians live longer than vegans. Vegetarians also consume Dairy. Of course, this is not anything that this channel would dare to report on, because it goes against their narrative. Another set of cherry picked studies and ignoring of the big picture. You should be ashamed

  20. I am really confused here . I cannot argue with the science but I feel that the doctor is biased against meat or dairy . So I can't tell if I am getting a true balance of information. there might be some positives of eating meat but obviously they would never be shown .

  21. So, despite eating food rich in choline, vegans don't produce TMAO — why? Is there some subtle difference between the choline in eggs and the choline in soybeans? Is there some other thing the TMAO producing bacteria like that's only food in meat and eggs?

  22. I'm just going to assume I'm not the first one that has said that people are now going to be paying to be full of bullshit.

  23. just get 3-3-dimethyl-1-butanol into your food and you should be fine. It effectively prevents bacteria from making the TMA from choline/carnitine. Look up the compond the and the associated studies.

    50ml from synthetic origin can be had for about 100 USD. This is not spam, I am not telling you where to get it.. I am surprised the scientist in this channel didn't come up with it himself.

    this is good news, SPREAD THE WORD GUYS

  24. Macrophage specific targeting of these TMAO producing bacteria could be an option if we knew the specific bacteria involved.

  25. Hello Doctor, does eating fish can elevate the TMAO i eat fish daily my Cholesterol test is within the range same with liver enzyme

  26. I love you Dr Greger. My Health has changed dramatically. I was misdiagnosed many times and placed on many types of medications my nephew said enough is enough and we started the whole food plant-based lifestyle three years ago and I feel fabulous and I am so grateful

  27. Yeah, okay… well it turns out that Choline is actually needed for many people … So cutting down on it is not the solution! Look at genes such as PEMT, BHMT08, MTHFD1.. Most people need Choline, the solution is not to cut down on products high in Choline at all !

  28. Read a review of the research before you decide.

    They said: “the high correlation between urine and plasma levels of TMAO argues for effective urinary clearance of TMAO.” In other words, even if eating food does increase total TMAO levels, most people are able to quickly and efficiently clear that TMAO from their blood by excreting it in the urine. This makes it doubtful that dietary factors alone explain chronic elevations in TMAO.

  29. I am a dialysis patient, and I'm also on warfarin, so my diet is extremely constrained when it comes to fruit and vegetables (many are high in potassium, and green leafy vegetables are high in vitamin K1). I eat a protein-rich diet because I've been instructed to by the renal dietitian. I can't eliminate TMA in my urine, because I have no kidneys. What can I do?

  30. I've done some more research on this, and I found a different web page about people who suffer from a related illness called tmau that in essence the bacteria breaking down choline and carnitine in their colons cause them to have a foul fishy odor. They said that they are working on an over the counter supplement that will in essence stop these bacteria from breaking down choline and carnitine and thus solving the problem by 2020. Until then, they said what works for them is grap seed extract and resveratrol supplements. I also noticed that fish followed by poultry and eggs are the worst offenders. So, contrary to what people have been led to believe, the worst meat for you is probably fish and poultry. So, if you are going to eat meat, might as well just eat beef. Although even this tmau group suggests that it is best to reduce all meat, egg and dairy consumption as much as possible. I was already taking reveratrol, but now I am going to add a grape seed extract supplement, as well as increasing the amount of olive oil and grape seed oil and balsamic vinegar I use (they all contain DMB), and when the new supplement comes out in 2020 I will start taking it, too.

  31. For all the skeptics posting here, note that Greger is not a "vegan" per se even though he recommends a whole food plant based diet. As proof, here's a video that suggests meat consumption can be beneficial for the 1:40,000 with a rare genetic disorder that prevents the natural formation of carnitine. Fortunately, a carnitine supplement can also avoid the symptoms of the condition, so even with the disorder, you can still avoid the other problems associated with meat with a whole food plant-based lifestyle.

  32. Morning routine, water with lemon, and now as the weather is warm sitting on my terrace getting some sunshine and slurping an oatmeal with bunch of cherries and blueberries and binge watching Dr Greger’s videos. Meanwhile most of my relatives and friends are working on boosting their TMAO’s with prosciutto and eggs etc…

  33. Okay, I'm much more worried about my LMAO levels now. This channel is "", yet it promotes anti-nutritious and even toxic diet…

  34. Only a problem if your eGFR rate is lower than 90. If your kidneys are working well TMAO is not a risk factor. See 7:03 of .

  35. I have been a vegetarian for many years because of having heart disease. How come I have sky high TMAO levels and low choline levels? Can this be due to the 500mg of Carnitine which I supplenent daily? I am stuck.

  36. ”The main NEJM study linking TMAO to an increased risk of cardiovascular disease is not as conclusive as many promote. First of all, only those at the upper quartile of TMAO level had a significant increase in cardiovascular disease risk. Lower elevations had no significant correlation.

    Second, those with increased TMAO and cardiovascular disease risk also were more likely to have diabetes, hypertension and a prior heart attack; furthermore, they were older, and their inflammation markers, including myeloperoxidase, a measurement of LDL inflammation, were significantly higher. With so many confounding variables, it is impossible to say the TMAO had anything to do with the increased cardiovascular disease risk.”
    – Diet Doctor

    For those who eat vegan and do not mind eggs, it seems in one study where red meat did increase TMAO, no elevation was found by choline as a precursor.

  37. Every doctor has his own fucking theory for food. Some say if you turn vegan you die, some say that for keto. I'm like wtf am I supposed to consume ? Seriously ! YouTube is the most misinforming place of information to collect. Everything's contrasting !

  38. TMAO Healing…..
    Dr weng alternative treatment therapy uses herbal remedies to cure any prolonged and incurable diseases of all types.
    An estimated 80% of people around the world use herbal medicine. studies have shown that certain herbs are effective in treating a number of health issues like Tuberculosis, Parkinson's, multiple Sclerosis, Lupus, polio, Asthma,Prostate Enlargement allergies, premenstrual syndrome chronic fatigue, all types of cancerous diseases, cirrhosis,nasal polyp etc
    I'm a practicing medical doctor and I like to refer my patient to Dr Weng, a Chinese herbal doctor who is the last resort when medication fails or inadequate .it may interest you to know that I was recently cured of Tmao by this same Dr Wengs herbal remedies. if you are experiencing any sickness and desire quick healing, you can send me an email to my mailbox so that I will give you the contact of the herbal doctor.My email is [email protected]

  39. Almonds and legumes contain choline and carnitine , why not mention of it ? I sometimes find this channel to cover-up the flaws of vegetarian diet to quite an extent and it only exists to challenge the keto channels.
    P.S. I'm a vegan ,myself.

  40. Peas,Carrots ,Tomatoes,potatoes,soybeans, Cauliflower ALL make us produce more TMAO than Beef. Greger is a cherry picking fool.

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