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Treatment of Fish Odour Syndrome (Trimethylaminuria) with Ayurveda

Introduction

Trimethylaminuria (TMAU) is an inherited condition (in an autosomal recessive fashion) in which the victim emits rotten fish smell. Hence it is also known as fish odor syndrome or fish malodor syndrome. TMAU is a psychologically disabling condition as it has a huge psychosocial impact. This disorder is caused due to an inherited deficiency of flavin mono oxygenase 3. This enzyme is crucial for the trimethylamine metabolism. Trimethyl amine is a tertiary amine whose odor resembles of a rotten fish.

Odorous trimethyl amine is oxidized by flavin mono oxygenase 3 into non odorous trimethyl amine – N – oxide. This mechanism is corrupted in TMAU patients. Hence TMA gets accumulated in the body and it may release out of the body through sweat, urine, expired air and reproductive fluids. Thus TMAU victims emits fishy odor around the clock, but the intensity may vary from moderate to severe.

Incidence of TMAU is noted more in females than males, as the estrogen & progesterone levels may exacerbate the condition. The condition may worsen when the victim nears his puberty and in females it is most intolerable during menstrual cycle and menopause. The smell can become fishier while having oral contraceptives.

Secondary cases of TMAU can be noticed in persons who had prolonged therapeutic administration of choline for Alzheimer’s disease or Huntington’s chorea.

Differential Diagnosis

Bacterial vaginosis, urinary tract infections, cervical cancer, advanced liver of kidney diseases, foul smelling urine (especially in children) due to colonization of Aerococcus urinae bacteria in urinary tract, all these may mimic the TMAU symptoms. These may have a raised level of trimethyl amine in urine, but there will not be any underlying genetic factors.

Trimethylaminuria & Ayurveda

In Ashtanga Hrudaya, uttara stana Acharya details about baala graham. It is mentioned that, a child seized by Andhapoothana graham will emit fishy odor. Treatment protocols aimed at andhaputana graham can be made use in TMAU patients. Also aggravation of thridosha especially pitta can be noticed in TMAU patients. The foul smell is in account of aggravated pitta. So while managing TMAU, balancing pitta is of prime importance.

Treatment of Trimethylaminuria

It is really rhapsodic that TMAU has no complete cure, as it is connected to genetic factors. But there are many simple techniques to improve the quality of life in TMAU patients.

Stress level & hormonal changes – avoid stress & relax well. Increased stress may cause hormonal changes leading more perspiration. More the perspiration more fishy smell. One may resort to pranayama and meditation techniques to ease the mind. This step is very crucial in TMAU management, as the patient may suffer from low self esteem, poor psycho social connections, depression etc.
Avoid all the parameters that can cause excess perspiration like strenuous exercises, fever etc.
Wash the body with acidic ph soaps (5. – 6.5) and laundry on regular basis
Diet – limit the intake of marine fish (contains higher concentration of TMAO, a precursor of TMA), egg yolks, red meat, raw soybeans, mustard seeds etc. limit the ingestion of Brussels sprout, as they may inhibit flavin monooxygenase 3 enzyme.
Supplement with riboflavin, as flavin monooxygenase 3 has a flavin cofactor

Herbal Remedies for Trimethylaminuria (TMAU)

Planet Ayurveda offers various herbal remedies for Trimethylaminuria that provides effective results on symptoms associated with this disease.

1. Green Essentials

Capsules Green Essentials are among the unique products manufactured by Planet Ayurveda. These capsules nourish the cells and fight against various ailments. These capsules are known to clear heavy metals so these capsules are quite effective for the patients suffering from fish odour syndrome.

Dosage:- 1-2 capsules twice daily.

2. Manjishta Capsules

Prepared from the standardized extract of rubia cordifolia herb. It is well known for its blood purifying properties. It helps to detoxify the body. It boosts the immune system. It is also coolant in nature and hence reduces perspiration and aggravated pitta.

Dosage:- 1 cap twice daily after food with lukewarm water.

3. Gandhak Rasayan

Gandhak Rasayan is an Ayurvedic medicine used in the treatment of skin diseases, provides nourishment, improves digestion strength and mostly indicated in the diseases arising due to depleted body tissues, itching, skin diseases and other toxic conditions.

Dosage:- 2 tablets twice daily.

4. Kaishore Guggul

Kaishor guggul is a very famous Ayurvedic medicine that acts as a natural blood cleanser, aging skin health promoter and is widely used in various skin diseases. It contains natural blood purifying herbs such as Triphala and Giloy. Triphala is the nature’s best remedy for detox as it removes toxins within the blood and therefore useful in all metabolic disorders.

Dosage:- 2 tablets twice daily.

5. Navkarshik Churna

It is very effective in controlling TMA level in blood. It corrects the protein metabolism and cleanses the blood. It is very effective for pain management in arthritic condition. As the name indicates it contains nine ingredients, each taken in karsha pramana (12 gms). The ingredients are amalaki (emblica officianalis), haritaki (terminalia chebula), vibhitaki (terminalia bellerica), neem (azadirachta indica), vacha (acorus calamus), manjishta (rubia cordifolia), katuki (piccorrhiza kurrao), guduci (tinospora cordifolia), daruharidra (berberis aristate). It balances the tridoshas.

Dosage:- Half tsp daily after meals.

6. Neem Oil Mixed With Jatyadhi Oil

For external application, mix neem oil with jatyadhi oil and apply on the affected skin. Jatayadi oil is an Ayurvedic medicine used for the external application as it heals the wounds quickly. It is applied over the infected skin diseases. Jatyadi oil balances Pitta and kapha doshas.

Neem oil has immense benefits. Neem oil helps in cleansing and healing the wounds quickly. It is useful in numerous skin diseases.

7. Royal Honey Shower Gel

Use Royal Honey Shower Gel for bathing as it contains natural ingredients that are anti-bacterial and anti-septic in nature that helps in relieving the bad odour.

It is true that complete cure of TMAU is not possible, as this disease is hereditary and has some genetic connections. But the above mentioned herbal products are guaranteed to prevent the progression of TMAU and can effectively manage the fishy smell of TMAU. These products are 100% natural & safe as it does not contain any preservatives, artificial colors, addictives, binders, fillers etc.

Top 7 Pain Relieving Remedies in Ayurveda Without Aspirin

Painkillers or analgesics are one of most widely categories of medicines. Analgesics are used at every instance, either it is traumatic or other complications. These are used for a variety of health conditions such as joints pain, migraine, arthritis, stomach pain, toothache etc.

As per modern classification, there are two categories of analgesics:

Narcotics
Non-narcotics

The basic principle of these painkillers is that they break the message transmitted from the affected part to the brain through neurons. Analgesics either break the pain signals arriving from the body parts to the brain or interrupt the brain to receive the message by neurons transmitting the pain signals. The side effects of these analgesics are obvious such as nausea, diarrhoea, pruritus (itching sensation), tenderness, jaundice and severe pain in the right upper quarter of the abdomen.

It has been proved in the research that the treatment with a product containing diclofenac sodium as topical applicants is linked with liver dysfunction, resulting in severe hepatic reactions, liver transplantation or even death.

Management of Pain according to Ayurveda

Ayurvedic approach to pain is holistic and looks to place the root cause of the disease, in contrast to simply dealing with the symptoms only.
The classical Ayurvedic text specifies about the species of plants that are used for muscularity relaxants and for other pain management.
Ayurveda uses single drug or multiple drug mixtures of herbs as well as mineral compounds for relieving pain.

Ayurveda Categorises The Painkillers into 3 Groups

Local Analgesics
Central Analgesics
Body-ache medications

Local Analgesic : These analgesics are topically applied to a particular part of the body and include paste preparations such as Belladonna.

Central Analgesics : These analgesics are more powerful than local analgesics and sometimes are combined with strict dietetic restrictions such as Dhatura.

Body-ache Medications : These analgesics are used in Ayurvedic practice to fight against stress and fatigue. There are more than 100 plants in Ayurveda that are recognised to have pain relieving properties such as Patala and Balam.

Various Herbs and Plants Described in Ayurveda as Natural Painkillers are

Garlic for Earache:

Garlic has been traditionally used in rural India for earache.
Garlic contains certain active ingredients such as sulphur, selenium and germanium which have positive physiological effects on pain.

How to use: Pour 2 drops of warm garlic oil into the affected ear for 7-10 days until it is completely cured.

Honey for Mouth Ulcers:

As a part of lifestyle, Ayurveda suggests honey gargle for mouth sores.
It is recommended for better voice, improved speech and to prevent all types of infections and inflammation.
It is very effective in decreasing painfulness and heals the tissues as well.

Vinegar for Acid Reflux and Heartburn:

In a research, it was concluded that there are good results of vinegar in heart burn and acid reflux particularly the Apple cider vinegar.

How to use: Take 30 ml vinegar mixed with water after a heavy meal to make digestion and metabolism smoother.

Clove for Toothache Relief:

Cloves have been used by Indians since thousands of years. It contains eugenol which works as anaesthetic and has anti-bacterial effects.
It has also been reported that the consumption of 2 gm clove powder improves the cholesterol level and maintains pH in the gastro-intestinal tract that in turn avoids all kinds of oral infections.

How to use: Apply clove oil to the affected tooth or chew 1-2 cloves.

Ginger Root for Muscle Pain:

Ginger has positive effects on reducing swelling and stiffness as well. The main element of ginger is Gingerols that is effective in treating muscular pain.

How to use: Include 5 gm fresh ginger or 2 gm dried ginger as a part of your diet to prevent muscular and joint pains.

Treatment of Diabetic Pain with Turmeric:

Ayurveda suggests the use of turmeric as a part of diet to avoid the problems of diabetes as well as pain associated with it. It is considered as one of the most effective natural pain relievers known to exist and also possesses anti-inflammatory properties. It contains curcumin as an active ingredient which is responsible for its properties.
Turmeric decreases the pain and irritation experienced by patients suffering from arthritis, fibromyalgia, IBS, arthritis due to its anti-inflammatory properties.

Buttermilk for Pre-Menopause:

Ayurveda suggests buttermilk for pre and post-menopausal syndromes as well as for menstrual pain. It is also effective in curing vaginal infections as well as itching. It is also effective in curing yeast infection. It is quite favourable in treating gynaecological conditions.

How to use: Take a plain glass of buttermilk with cumin seeds. You can buttermilk twice or thrice a day. The calcium content in buttermilk dispassionate the physical and psychological irritability associated with PMS.

Cherries:

Cherries are packed with certain anti-oxidants known as anthocyanins which are responsible for giving them red colour and for relieving pain.
Research has indicated that anthocyanins, an active element in cherries is ten times more beneficial in lowering pain than common painkillers such as Ibuprofen without causing any side effects.

Epsom Salt Bath for Leg Pain:

Epsom salt that is rich in magnesium, is an excellent pain reliever. This remedy is also helpful for patients suffering from arthritis as it soothes leg pain. Salt also possesses anti-bacterial and anti-inflammatory properties which makes it effective in relieving pain. Regular soaking of infected parts in warm salt water acts better than topical painkillers and antibiotics.

Massage/Snehana:

In the world of Ayurveda, oil massage or sneham is considered as a very rewarding therapy for treating pain and other ailments. It pacifies Vata, mobilises the toxins, maximises circulation and therefore relaxes the overall body.

Cumin:

Cumin is an aromatic spice and mild pain reliever.

How to use: For stomach pain, make a mixture of 1/3 tablespoon of cumin powder, a pinch of asofaetida and a pinch of rock salt. Mix and chew it thoroughly followed with a drink of warm water