High TMAO, has little to do with diet and everything to do, with being tired & hungry – it starts with the heart and this makes the colon leak TMA, increasing TMAO
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Avoiding animal protein won’t fix your TMAO problem
High TMAO, has little to do with diet and everything to do, with being tired & hungry – it starts with the heart and this makes the colon leak TMA, increasing TMAO
Your TMAO levels are high….
Ouch ! TMAO is the new bad guy.
Just like cholesterol, TMAO, is associated with cardiovascular disease, although, it’s not clear, whether it is a cause, or a consequence.
Either way, it’s increasingly being measured.
And when it is high, your doctor will sit up and take notice, because it hints, that you’re, in REAL trouble.
A heart attack waiting to happen
Current guidelines consider
- Less than 2 uM as low risk
- 2 – 9.9 uM as intermediate risk
- More than 10 uM, as high risk
Since, there is no pill to swallow, yet, if your TMAO levels are high….. your doctor, will want to get your cholesterol levels, down, stat.
NB. You’re a heart attack waiting to happen !
Now in an ideal world, what gets measured, should be managed, but to manage a problem, you need to know, what is causing it. Scientists are still working out the details.
The TMAO from start to finish
TMAO is ultimately a bacterial metabolite. The bacteria, living in your gut, produce trimethylamine, when they tuck into certain nutrients, typically found in animal protein.
The source nutrients are choline, betaine and carnitine.
These nutrients are metabolized by gut bacteria, into TMA. As the TMA, passes through the liver, the liver pops an oxygen onto, some of the TMA, to create TMAO.
Both TMA and TMAO circulate.
As they pass through the kidney, the kidney filters them out.
High TMAO
So when TAMO accumulates, you could blame
- The diet/ gut bacteria for increased production.
- The liver for being overzealous
- The kidney, for keeping the “toxin”, instead of pee-ing it out.
Now the current thinking is……..
It starts with THE DIET.
The two for one deal
So, if your TMAO levels are high, odds are your doctor, will tell you to cut out, meat and eggs. Since these are the foods, with the highest carnitine and choline, levels.
This simple dietary intervention, will fix everything…
It will lower your TMAO and your cholesterol, AT THE SAME TIME !
Something fishy…
Fish, is also FULL OF TMAO. And, odds are, this is something your doc, will encourage, you to eat more. It doesn’t add up…
This inconsistency, prompted a group of researchers based in Poland, to explore, where the TMAO is coming from. They had a hunch, it was not from the diet, so they decided to explore, TMAO levels, in rats, that had heart disease, thanks to bad genes, not a bad diet.
Spontaneously hypertensive
The clan of rats they studied, are known as spontaneously hypertensive heart failure (SHHF) rats. They’re considered to be a model of metabolic syndrome with hypertension, type 2 diabetes and congestive heart failure.
Basically they’re in trouble, no matter what they eat.
And, their health problems manifest early, heart failure appears at 10 months of age. But, there problems are relatively heart specific, kidney function and liver function, is more or less, normal. This makes them a good model to study.
Locating the problem
The team, kicked off their study, by measuring TMA and TMAO levels, in “EVERYTHING”.
They confirmed SHHF rats have high TMAO levels.
But, there was nothing to suggest, the increase had anything to do with the liver or kidney. When they calculated the level of liver TMA oxidation, it was the same, as in healthy rats. And urine levels, were actually significantly higher, implying the SHHF rats, kidney, was doing a good job of clearing, the “toxin”.
What was different, was the level in their poop.
In the case of the SHHF rats, there was a lot less.
The extra TMAO
The team did a little more maths……..to assess, gut permeability and concluded, SHHF rats, weren’t making more TMAO.
They were absorbing more.
Something was wrong in the gut……….
Gutted
Next, the team, took a look inside the gut of the animals, to see what was happening. Things did not “look” normal.
Histopathological evaluation of the small intestine. © 2020 Adrian Drapala et al
Both the villi in the jejunum and the enterocytes, on the villi, were shorter.
Things didn’t look much better, in colon, the place where most of the TMA, is likely to be made.
Histopathological evaluation of the intestine. © 2020 Adrian Drapala et al
One of the reasons, the gut wall, looked different, is blood flow to these nether regions, is diminished, when cardiac output is compromised.
Less blood……………
Less oxygen and nutrients.
It’s hard to perform well, when you’re hungry and tired.
Tired & hungry
This research suggests the TMAO problem, has little to do with diet and everything to do, with being tired & hungry. The tired and hungry starts, with the heart, this leads to a tired and hungry, colon.
Which then leaks………..
But my heart is NOT FAILING
Maybe not, yet. However, heart failure is more common that WE THINK and, the heart failure most associated with metabolic troubles, is harder to pick up, early on. Heart failure is the END, literally and figuratively.
If you’re insulin resistant, your heart is taking strain…….
This is why one of the tell tail signs of metabolic syndrome, is high blood pressure. Rising TMAO, is a sign, you’re crossing a threshold. It’s time to get, SERIOUS !
Tackling TMAO
Starts with getting the blood flowing, there are lots of ways to do this, moving more, will help, so will dietary changes. But, you need to make the “right” changes…..
CUT CARBS, not choline and carnitine.
Both choline and carnitine, are nutrients that help create BETTER BODY CHEMISTRY. They’re NOT the bad guys. In fact, choline is an underappreciated essential nutrient, that is easy to be short of. Among it’s claims to fame, it helps move lipids around the body, safely……… if you’re supplies are low, fat metabolism will be adversely impacted. Click here to learn more.
Further reading
Are eggs for breakfast, good or bad ?
Eggs are more than just cholesterol, they’re full of goodies. They won’t up your odds of suffering a heart attack, in fact, they might just do the opposite.
High TMAO levels are just a sign you’re living a high pressure life
TMAO acts as a piezolyte, that means, it helps to protect the fish’s proteins, from being “crushed” by the water pressure
Blood vessel torture can save hearts and lives
Remote ischemic preconditioning, uses a blood pressure cuff, to deliberately cut off the blood supply – it’s cruel, but in the end, practice makes perfect