TMAO Testing at LaVida: Assess Cardiovascular Health and Disease Risks

TMAO (or trimethylamine N-oxide) is a metabolite produced by gut bacteria. Briefly, nutrients such as phosphatidylcholine (also known as lecithin), choline, and L-carnitine are abundant in animal-derived products such as red meat, egg yolk and full-fat dairy products. When consumed, these nutrients are processed by gut bacteria resulting in the release of various metabolites including TMA (trimethylamine) into the blood. TMA is then transported to the liver where it is converted into TMAO which has been shown to regulate various physiological processes involved in the development of atherosclerosis.

Researchers are discovering more and more associations between TMAO levels and the development of multiple inflammatory conditions. These include heart disease, type 2 diabetes, chronic kidney disease, cancer, and liver disease.

Use of the TMAO test often occurs for more accurate risk prediction of a major cardiac event in patients undergoing elective coronary angiography and patients with acute coronary syndromes.

Clinical data also supports using TMAO testing to get a clearer idea of the risk for all-cause mortality in patients with peripheral artery disease, heart failure, chronic kidney disease, and after a myocardial infarction.

To undergo the TMAO blood test, patients fast overnight and refrain from eating fish or other seafood — including fish oil or krill oil supplements — the day before the blood draw to avoid false elevations in TMAO.

After a blood draw, TMAO levels are assessed in micrometers (μM). A reading of less than 6.2 μM indicates low risk of a major cardiac event, and the higher that number, the greater the risk.

High TMAO levels are associated with a high risk of developing cardiovascular disease. In addition, there is a 2.5 times higher risk of heart failure or stroke compared to normal levels.

 Factors that can lead to increased TMAO levels include:

1.  Imbalance in diet and gut microbiome
2.  Chronic insomnia or sleep apnea
3.  Stress
4.  Smoking
5.  Aging can also contribute to higher baseline

 1. Lifestyle modifications
 Adopt appropriate eating habits
 Balance the gut microbiome
 Consume a high-fiber diet
 Exercise appropriately as recommended
 Monitor TMAO levels as advised by a healthcare
 provider

 2. Consume vitamins and supplements
 B-complex vitamins
 Vitamin C
 Vitamin D
 Red wine (in moderation) or Resveratrol
 Specific probiotics
 High-fiber foods and fruits and
 vegetables
 TMAO levels