I saw this study where 3 out of the 15 guys who underwent this portosytemic shunts closure had symptoms of Tmau per urine analysis. Out of the 3, 2 were completely cured of Tmau and the third guy was not only because his condition came back. It's basically a malformation where a vein bypasses the liver so the tma does not get absorbed and goes straight to the blood system. Guys this can be huge for a lot of us. It's worth investigating. Not sure how dangerous the surgery can be but some of us do have this it might be worth the risk. It's essentially a cure. This won't help if you have the primary form though, the genetic malfunction.