Trimethylamine N-Oxide (TMAO): How Does This Molecule Fit Into Your Health and Diet?

Limit your consumption of red meat…  

Only eat egg whites and avoid the yolk…  

Always opt for low-fat or fat-free… 

Chances are you’ve heard dietary advice somewhere along these lines at least once or twice in your life. But where exactly did this advice come from? And is it truly sound advice that you should be following?

The answer to the former question comes down to a little molecule found in certain animal products known as trimethylamine N-oxide. But the answer to the second question is a little bit trickier. So today we’re going to dive into exactly what trimethylamine N-oxide is, the role it plays in your health, and most importantly – what you need to know to safeguard your well-being when it comes to this confounding compound.

What Is Trimethylamine N-Oxide (TMAO)? 

Trimethylamine N-oxide or TMAO is a type of gut bacteria metabolite. You see, your gut is home to millions of gut microbes that live in harmony with your own cells. They also work alongside your cells, and one crucial role these microscopic organisms play is in the breakdown, processing, and absorption of the nutrients you consume. 

This process is called metabolism, and when your body metabolizes food it gets broken down into smaller particles called metabolites. Certain foods tend to be abundant in a few specific nutrients known as:¹

• Phosphatidylcholine (also known as lecithin)
• Choline
• L-carnitine

As these nutrients are broken down and processed in your gut, your gut microbes release an array of metabolites into your blood – including a compound known as trimethylamine. Trimethylamine is then shuttled to your liver where your body converts it into trimethylamine N-oxide.

So exactly what foods contain an abundance of these nutrients that are precursors to trimethylamine N-oxide?

Foods That Contain Trimethylamine N-Oxide (TMAO)

Trimethylamine N-oxide is primarily produced via the consumption of animal products like:

• Red meat
• Fish and seafood 
• Eggs – particularly egg yolks
• Dairy products 

For this reason, some dietary guidelines warn against consuming large amounts of red meat, eggs, and other animal products. But on the flip side, many clinicians and health gurus promote a Mediterranean-type diet that’s full of fish and high-quality dairy for their health-boosting properties. 

So what gives? Does trimethylamine N-oxide really deserve its bad reputation?

Is Trimethylamine N-Oxide (TMAO) Really Bad for You? 

In recent years, some researchers have proposed that elevated TMAO levels may play a pivotal role in the disease processes of a number of health conditions, including:²

• Heart disease
• Hypertension
• Atherosclerosis
• Coronary artery disease
• Diabetes
• Renal failure
• Cancer

So the answer to the question, ”Is trimethylamine N-oxide really bad for you?” is – it’s complicated. 

Why Is Trimethylamine N-Oxide (TMAO) Toxic for the Human Body?

A simple blood test can yield specific individual TMAO levels. And while trimethylamine N-oxide is not necessarily toxic, elevated levels have been found to have some negative effects on the body, including:³

• Decreased reverse cholesterol transport
• Increased foam cell formation (A type of cell that engulfs lipids or fats)
• Heightened platelet aggregation or clotting
• Upregulation of proinflammatory pathways

But on the contrary, other studies have found that trimethylamine N-oxide may actually have the opposite effect – offering protective functions such as:^4,5

• Stabilization of proteins
• Protection of cells from osmotic and hydrostatic stress
• Preservation of mitochondrial energy metabolism

So, if trimethylamine N-oxide has been found to have both toxic and protective properties, can it really be the cause of disease? 

Trimethylamine N-Oxide (TMAO): Cause Vs Correlation 

So, is trimethylamine N-oxide an underlying cause of certain chronic health conditions or is it actually protective? The answer is – neither. 

While there seems to be sufficient evidence that there’s a direct link between elevated trimethylamine N-oxide levels and a host of chronic diseases, that does not necessarily mean that trimethylamine N-oxide is the cause. Rather, there is a direct correlation between the two. 

Elevated TMAO levels simply raise a red flag that there’s a disruption in the overall homeostasis of the body. So, if elevated trimethylamine N-oxide levels are merely a marker indicating a deeper physiological imbalance, what exactly can we do about it? 

How to Reduce Trimethylamine N-Oxide (TMAO) Levels

We’ve established that elevated trimethylamine N-oxide levels are simply a reflection of a disruption in the overall homeostasis of your body. Your trimethylamine N-oxide levels can be influenced by a number of factors including: 

• Diet
• Gut microbiome composition and activity
• The permeability of your gut lining
• The activity of liver enzymes

But when it comes to TMAO, the bottom line is that your levels are determined by the composition of your gut microbiome much MUCH more than any dietary foods that you are consuming. The key to reducing and balancing trimethylamine N-oxide levels is not necessarily restricting nutrients like choline, carnitine, or phosphatidylcholine, but rather eradicating dysbiosis and shifting the gut microbial composition to a healthier balance.

And the good news is, you have a ton of power over the balance and health of your gut microbiome. So let’s dive into what you can do to reduce your trimethylamine N-oxide levels and restore balance to potential underlying issues disrupting your microbiome.   

Prioritize Your Gut Health

Since trimethylamine N-oxide is created by the microbes that reside in your gut, it makes sense that the health of your gut is a pivotal aspect of decreasing trimethylamine N-oxide levels. The best ways to keep your gut happy and healthy include:

• Eating a diet that’s full of gut-supporting nutrients (more on that in a minute)
• Reinoculating your tummy with beneficial bacteria by taking a daily probiotic
• Incorporating nutrients and supplements that bolster the strength and integrity of your gut lining – like Collagen and Gut Shield
• Providing your microbiome with the prebiotics and fuel it needs to thrive – like Gut Calm or Bind-Aid 

While these gut-supporting supplements can play a monumental role in boosting your gut health, they’re all for waste if your diet doesn’t also support your gut health.

Eat a Healthy, Well-Rounded Diet

A healthy well-rounded diet is hands-down one of the most powerful weapons you have against chronic disease. And while TMAO may be linked to certain animal products, it certainly doesn’t mean you need to entirely avoid steak, eggs, or bacon in your diet.

Simply focusing on eating a variety of nutrient-dense, non-inflammatory, and most importantly real food is the key to a healthy diet. Focus the majority of your meals around fresh vegetables and fruits, high-quality protein, and healthy fats. And do your best to avoid inflammatory foods like refined oils and sugars, artificial sweeteners, and processed foods that irritate your gut.

Minimize Your Toxic Burden

We’re all exposed to countless pollutants on a daily basis. And over time, these pollutants can begin accumulating within your body. This slowly increases what’s known as your toxic burden, or toxic load.

A high toxic burden can disrupt your hormones, burn out your immune system, damage your gut, and cause chronic low-level inflammation – all this can tip the scales in favor of elevated TMAO levels and chronic disease. While you can never entirely eliminate toxins from your life, taking steps to minimize your toxic burden can go a long way. Click here to learn the exact steps you can take to begin decreasing your toxic burden right away. 

Uplevel Your Sleep

Sleep deprivation is like kryptonite to your health. Consistently logging inadequate sleep (both quantity and quality) is one of the best ways to disrupt every single facet of your well-being and skyrocket your trimethylamine N-oxide levels. So how exactly can you uplevel your sleep?

Click here to learn exactly how you can uplevel your sleep and optimize your shut-eye.

So, How Concerned Should I Be About Trimethylamine N-Oxide (TMAO)?

While an increase in trimethylamine N-oxide in and of itself is not necessarily harmful, this little compound is an increasingly useful marker in determining the risk of a number of conditions. Elevated levels of this complex molecule is one way your body clues us into an upstream underlying issue that needs to be addressed. 

So if you’ve received a test confirming elevated TMAO levels, it’s certainly a concern, but is by no means a diagnosis that leaves you powerless. On the contrary, these signals from your body are the perfect chance to tune in and reclaim the undeniable power you have over your own health and well-being. 

That’s why I’m dedicated to bringing my patients and readers researched-backed and easy-to-implement resources. When it comes to your health, you deserve the knowledge and tools needed to hop in the driver’s seat. So if you’re ready to take charge of optimizing your health, I encourage you to head over and check out my blog with hundreds of articles designed to help you do just that. And if you’re ready to take it even deeper, you can sign up for my weekly newsletter by inputting your information in the form below.

Now it’s time to hear from you. Were you surprised to learn the role that trimethylamine N-oxide plays in your health? What steps are you taking to safeguard and optimize your health? Leave your questions and thoughts in the comments below!

References:

1. TMAO (Trimethylamine N-Oxide) | Test Detail | Quest Diagnostics
2. Trimethylamine N-oxide: A harmful, protective or diagnostic marker in lifestyle diseases? – ScienceDirect
3. Trimethylamine N-oxide (TMAO) Is not Associated with Cardiometabolic Phenotypes and Inflammatory Markers in Children and Adults | Current Developments in Nutrition | Oxford Academic (oup.com)
4. Frontiers | Microbiota-Derived Metabolite Trimethylamine N-Oxide Protects Mitochondrial Energy Metabolism and Cardiac Functionality in a Rat Model of Right Ventricle Heart Failure | Cell and Developmental Biology (frontiersin.org)
5. Trimethylamine N-oxide: A harmful, protective or diagnostic marker in lifestyle diseases? – ScienceDirect