CAN DIET MAKE BAD BODY ODOR WORSE?

Q: My husband has horrible body odor. He showers every day, but he still smells terrible. It’s not only his underarms; it’s his whole body. I think it’s coming from the inside. Could certain foods be causing it? Please help.

A: We don’t know why your husband smells. However, there is a condition called “trimethylaminuria” in which a person’s sweat, breath and urine smell like rotten fish (Drug Discovery Today, July 2020). This condition is rare, and scientists have not done much research on its treatment. The smell can be controlled in part by avoiding fish, poultry, eggs and red meat in the diet and washing with a low pH cleanser such as Alpha Hydrox moisturizing body wash, Cetaphil, CeraVe foaming facial cleanser or Sebamed.

In mice, a garlic compound called allicin helped reduce the buildup of TMAO that causes the bad smell. We don’t know if eating garlic would help humans, however. You may need to find a health professional who is familiar with trimethylaminuria diagnosis and treatment to see whether this is responsible for your husband’s problem.

Q: I have been taking atenolol for some time now, and I am feeling very foggy and tired. My doctor suggested I change to losartan. I have read a number of patient reviews about the side effects of losartan, and I am concerned. Is there any data about the relative safety of the two drugs?

A: Atenolol is an old-fashioned beta blocker heart medicine. It is no longer considered a first-line blood pressure treatment unless the patient has angina or irregular heart rhythms (American Journal of Cardiovascular Drugs, July 25, 2020). Side effects such as fatigue, slow heart rate, lethargy and depression are not uncommon.

Losartan is generally well tolerated though some people develop a cough. Other side effects include digestive upset or fatigue.

Guidelines from the International Society of Hypertension recommend starting treatment with an ACE inhibitor like lisinopril or an ARB such as losartan (Hypertension, June 2020). You can learn more about the pros and cons of these medications and many nondrug approaches in our eGuide to Blood Pressure Solutions. This online resource is available through the Health eGuides section at www.PeoplesPharmacy.com.

Q: It’s summer and the “wear sunscreen” drumbeat is loud and clear.

I live in the South where local ponds and open storm drains make mosquitoes a big problem. I am more concerned about Zika, West Nile virus and chikungunya than wrinkles and skin cancer. So DEET is my skin application of choice.

Do we know anything about the combination of sunscreens and DEET? Is there reason to suspect that using both makes either less effective or more harmful?

A: Dermatologists have found that applying the insect repellent DEET together with sunscreen results in greater absorption of both compounds ( Journal of Dermatological Treatment, January 2016).

According to these scientists, picaridin would be a better choice for repelling insects if you also need sunscreen (which you mostly do). Although DEET is the gold standard, picaridin is about as effective and appears less likely to cause side effects. When used together with sunscreen, it reduces absorption of both compounds. You’ll find picaridin in several commercially available insect repellents. They include Sawyer Picaridin Insect Repellent, Natrapel 12-hour Insect Repellent, Repel Tick Defense and Ranger Ready Picaridin 20 Percent.