r/patm

I’ve had PATM for about 6 years, but it was never this bad until around 3 months ago. Before that, not many people seemed to cough around me. Now, it feels like around 95% of people react by coughing.
Sometimes I can hear people coughing repeatedly for around 5 minutes straight, even when they’re in a completely different room. The dramatic change over the past 3 months is what concerns me because I never experienced anything this severe during the previous 6 years.

What r ur experience with it, for those who tried it?

I’m a 17-year-old male, and I genuinely want to know how you guys manage dating and relationships while dealing with PATM. For me, it feels difficult to even be in a room with too many people for too long because people start coughing, and it makes social situations really hard.
How do you deal with dating, getting close to someone, and spending time with them without constantly worrying about their reactions? Have you found someone who understands your condition, or is your PATM less noticeable than others?
I’m not trying to judge anyone. I genuinely want to hear your experiences

I would like to ask the women in this community: Do all of you have PCOS (polycystic ovary syndrome)? Do you think there could be a connection between PATM and PCOS?

I’m 32 years old, and I have PCOS. I’ve been married for two years, but I haven’t been able to conceive.

Do you think PCOS could be responsible for my fertility difficulties, or could PATM also play a role? I would really appreciate hearing about your experiences, especially from women who have both conditions.

Bacteria testing based on stool is widespread, but unreliable. There is little known about the gut microbiome and how each bacterial species behaves inside it. It is just now being discovered.

Instead, a more concrete methodology would rely on established fecal tests for chymotrypsin, trypsin, and elastase (all used to break down protein) to detect any odor causing enzymes in the stool.

I have not looked into it yet, but the enzymes would be the ones related to odor such as methane-producing, sulfur-compound producing, toluene-producing, etc. The gas made in the gut should be a gas that somehow causes constipation for the host and gets across the gut into the blood.

It seems the established methods use antibodies, but a baseline would need to be measured from "normal" people to see how much of a particular enzyme they have, to see what is considered "normal." This could take decades, but its worth studying.

As for methane, which is shown to slow down the gut (causing constipation), a substance of note is bromoform, used in the cattle industry to prevent cow methane. It is toxic to humans, but I am sure a suitable dose or delivery method (perhaps directly to the colon via rectum) will come soon. Or other substances exist to prevent methane in the human gut. Ask AI for more.

Further, a SIBO test might not detect this mechanism. SIBO relies on the methane gases climbing up through the stomach. In this case, methane is contained in the colon, but the secondary effect being bodily toxins unable to leave and hence being emitted from us due to constipation preventing toxins from leaving quickly. This is compounded by most SIBO tests requiring you to fast beforehand, preventing colonic effects from being shown.

Overview & Scientific Context

PATM (People Allergic To Me) is characterized by individuals emitting volatile organic compounds (VOCs), skin gases, or metabolic byproducts that trigger allergy-like reactions (coughing, sneezing, eye irritation) in bystanders. Research led by Professor Yoshika Sekine at Tokai University suggests PATM involves a diminished hepatic (liver) capacity to metabolize volatile compounds like toluene and sulfur chemical complexes. Instead of being excreted via urine, these compounds diffuse through the skin as dermal gases at significantly elevated rates. A subset of sufferers may also present with Secondary Trimethylaminuria (TMAU) caused by gut dysbiosis.

The strategy below focus on reducing dietary precursors, improving Phase II liver detoxification, correcting gut dysbiosis, and altering skin surface gas chemistry.

Phase 1: Dietary Control & Precursor Reduction (Weeks 1–4)

The immediate goal is to lower the volume of volatile organic compounds and volatile sulfur compounds (VSCs) that the body must process.
TMAU / Nitrogen Precursor Restriction: If PATM stems from gut-driven metabolic odor, restrict foods extremely high in choline, carnitine, and lecithin, which gut bacteria convert into odorous volatile compounds.
Avoid/Limit: Egg yolks, liver, kidney, soy products, and deep-sea fish/shellfish. Focus on freshwater fish, moderate lean poultry, and plant-based proteins.
The "Clean Gut" Baseline: Avoid artificial preservatives, alcohol, heavily processed foods, and refined sugars. These alter sebum composition and feed opportunistic gut bacteria that synthesize petrochemical and aldehyde byproducts.
Histamine & Sulfur Management: If bystanders experience instant respiratory or mast cell reactions, temporarily trial a low-histamine diet. Limit fermented foods (aged cheeses, vinegar, sauerkraut, kombucha) and high-sulfur foods if you notice reactions worsen after eating them.

Phase 2: Hepatic (Liver) & Metabolic Support

Because research shows PATM is strongly tied to poor clearance of xenobiotics, optimizing liver detoxification pathways is essential.
Phase II Conjugation Support: Supplementing with N-Acetyl Cysteine (NAC) or Glutathione assists the liver's sulfation and glutathione conjugation pathways, helping it process volatile aromatics before they reach the sweat glands.
Targeted Anthocyanin Protocols: Incorporating Blackcurrant Powder or standardized blackcurrant extracts (aiming for 105–210 mg of active anthocyanins daily) acts as a metabolic modulator. Blackcurrant anthocyanins upregulate native AMPK signaling, boost cellular antioxidant capacity, and promote metabolic flexibility.
Intestinal Binders: Take activated charcoal or copper chlorophyllin (100–300 mg daily split into doses). These supplements act as internal magnets in the gastrointestinal tract, binding to volatile organic compounds (like free trimethylamine) so they are excreted through stool rather than passing into the bloodstream and escaping via skin pores.

Phase 3: Gut Microbiome Axis Reset (Concurrent)

Metabolic byproducts emitted through the skin are deeply influenced by the gut-skin axis.
pH & Bacterial Modulation: Use high-quality, clinically validated probiotic blends containing Lactobacillus and Bifidobacterium strains. These bacteria help acidify the intestinal lumen. A lower intestinal pH converts volatile, absorbable gases into an ionized form that cannot easily cross the gut lining into the bloodstream.
Prebiotic Fuel: Blackcurrant powder acts as an exceptional selective prebiotic, actively expanding populations of beneficial gut flora while reducing systemic, low-grade intestinal inflammation that alters skin gas emissions.

Phase 4: Topical & Dermal Adjustments

You can alter the surface of your skin to minimize how volatile gases volatilize into the surrounding air.
Acidic Body Washes: Use soaps and body lotions formulated at a low, slightly acidic pH (pH 5.5–6.5). Keeping the skin mantle acidic helps retain volatile alkaline compounds on the skin surface, preventing them from evaporating into the air as rapidly.
Sebum Control: Maintain a clean skin barrier using zinc-based topical applications or diluted natural astringents to alter the surface sebum so it does not feed gas-producing cutaneous microbes.