Ask The Doctor

Medical Conditions Can Cause Body Odor

Dear Dr. Garner, 

It’s been eight years since my husband died. One of the biggest things he used to do for me is to tell me when my clothing needed adjustment, or my hair was out of place.
Recently at church, I had a mortifying experience. My friend told me that I had a problem with body odor. She told me that she and others had noticed I had a very unpleasant smell, and perhaps I was not showering enough.
I was thinking how my husband would have been the first to tell me about my problem if he were here.
I shower two times a day and use deodorant. I cannot smell a problem.
Since my friend spoke to me, I have been staying home most of the time, and I plan to cancel invitations I have received for Christmas parties.
Is there anything I should be doing from a medical point of view?
Body Odor In Bayside

Dear Body Odor,
Body odor smells have several causes, one of which is not showering enough or using enough deodorant.
Many times, as in your case, it is beyond the control of the person with bad odor and has nothing to do with personal hygiene.
Causes can include things you eat, such as onions, garlic, curry and dairy products.
Other times, it may be due to a medical problem, such as diabetes or an overactive thyroid; kidney or liver disease; or hormonal fluctuations like one gets at the time of menopause. Mental health disorders are notorious for creating certain specific body odors. Psychiatrists can actually tell a patient with schizophrenia by his or her smell. There is a very distinctive odor.

Medication May Be the Cause
Pills you are taking may also be the culprit. Fish oil, antidepressants, anticholesterol, antiseizure and migraine headache medications all have body odors associated.
On the other hand, parsley, cilantro and chlorophyll work wonders in neutralizing the smell.
You should keep a diary of what you eat. Write everything down, even if you think it is not significant.
Then you should write down all the pills, even the over-the-counter ones that you take, and when you started using them.
Finally, you should schedule an appointment with your family doctor to have blood tests and a physical exam. This is very important as the body odor may be the only sign or symptom that can help your doctor diagnose a serious illness.
The first thing you should do while waiting for your appointment is to purchase over-the-counter antiperspirant and deodorant. The antiperspirants contain chemicals that block the sweat pores, thereby reducing the amount of perspiration that reaches your skin.
Deodorants can eliminate odor, not perspiration. They are usually alcohol based and make your skin less attractive to bacteria.
There are prescription antiperspirants that your doctor can prescribe if the over-the-counter ones do not work.
The problem has a scientific name, bromhidrosis, which means foul-smelling perspiration.
It is important to have a friend to confide in. Explain to your friend that you are having a medical problem evaluated. Ask that she tell you if there is any change in your body odor.
This is a problem just like high blood pressure. It should be treated on the same level of seriousness.
While the problem may be caused by medication(s), never stop taking your medications until you have discussed the situation with your physician.
I wish you luck on your search for a cause and am confident you will find the culprit.
Do not despair. This is not an uncommon problem, and you can be helped. It is not your fault or something that means you are not clean.
For now, you can use the items above to help reduce any body odor that might be related to food.
Please let me know of your progress, and have a Merry Christmas.

Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET, Tuesdays at 8 p.m. on Ch. 97 Time Warner and Ch. 30 Cablevision.
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