Unexplained body odor may stem from rare genetic disorder

People whose bodies or breath are foul-smelling despite their good hygiene have a frustrating lot in life: Their social lives and careers may be hindered by their fear of offending others with their odor, yet they don’t know what to do to make themselves smell better.

But new research may lead to relief for some who suffer from such chronic malodor.

Researchers at the Monell Chemical Senses Center tested 353 people who had sought help in understanding and dealing with the odors their bodies produced. Through a simple test, the scientists learned that about a third of them had a rare, but treatable, genetic disorder called trimethylaminuria. People with this condition lack the enzyme required to properly metabolize trimethylamine, a substance found in many common foods.

Healthy people’s bodies break down trimethylamine into smaller compounds that are then excreted through urine. But for those with trimethylaminuria, the substance remains in the body, causing them to exude a fishy smell through their breath, saliva, sweat and urine.

Trimethylaminuria is hard to diagnose without specialized tests, in part because the foul smell may come and go — body odor related to the condition depends largely on what the patient has eaten lately. The disorder is often not detectable during medical examinations.

Fortunately, once diagnosed, trimethylaminuria can be treated through dietary changes and sometimes through use of antibiotics to combat bacteria in the gut that might contribute to the odor problem.

Avoiding foods containing trimethylamine or its precursor choline can reduce body odor related to the condition. Those foods include milk from wheat-fed cows, eggs, organ meats, peas, beans, peanuts, soy products, brussels sprouts, broccoli, cabbage, cauliflower and some seafood.

An estimated 1 percent to 11 percent of the population may have trimethylaminuria, notes the study, published in August in the American Journal of Medicine. If you have a body odor problem you’d like to have diagnosed or to get more information about trimethylaminuria, contact Monell at bodyodorinfo@monell.org.

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