Reader alienated, unable to help emitting a bad odor

Dear Annie: I have horrible body odor and halitosis due to a rare medical condition called trimethylaminuria. It makes me emit several odors — mostly rotting food, ammonia and fish. However, there is no medical cure, and I struggle with the condition daily. Lately, with age, I have developed “old people odor” associated with nonenal. Around me, people very often cover their noses, cough, frown and make rude comments. My former boss made faces and covered her nose in my presence. I left that place of employment and have not worked for two years. I feel depressed and avoid leaving my home at all costs. Social interactions and mental stimulation from work are greatly missed, but what can I do when I smell and cannot help it?

Alienated Alice

Dear Alienated: What a cruel condition. Our culture has become more sensitive to many ailments and disabilities, but I’m afraid this one might still be a far frontier. I’m sure that you’ve spent plenty of hours researching this already. But a quick rundown of some possible treatments according to the National Institutes of Health, on the slim chance you haven’t tried these: Avoid foods with high levels of trimethylamine and its precursors, including milk, eggs, liver, peas, beans, peanuts, soy, Brussels sprouts, broccoli, cauliflower and seafood; ask your doctor about taking laxatives (to reduce the amount of time food spends in your system) as well as low doses of antibiotics; use soaps with moderate pH; take nutritional supplements such as activated charcoal; avoid stress and anything else that causes sweating.

You should see what accommodations an employer might be able to make for you. For instance, if you work in an office, can you have your own space?

Join an online support group and consider attending counseling to help deal with the emotional component. Try to remind yourself that when people react to the trimethylaminuria, they’re not reacting to the real you.

And to those of us who are unaware, let this be a wakeup call: Don’t turn your nose up at someone who offends it. The person might have no control over how he or she smells.