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EMBO Mol Med 15:e16525

4 6 Defect in Trimethylaminuria In subjects with trimethylaminuria, there is a disparity between the quantity of TMA acquired from the diet requiring oxygenation, and the ability of the hepatic microsomal enzyme system to oxidise this load, such that excess TMA accumulates and is excreted in the urine, but also appears in the sweat and other bodily secretions, and can be detected in the exhaled breath

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Inform PWH that this may cause breakthrough bleeding, but there are management options to help improve this