YOUR PROBLEMS SOLVED
Dear Mary
Q. May I humbly correct the advice you gave about the life-long friend who has developed an ‘unfortunate strain of body odour’? She is suffering from trimethylaminuria, a rare metabolic defect which causes a fish-like smell due to abnormal breakdown of choline. Simple blood and urine tests are available to confirm the diagnosis, often triggered by a fishy meal. Appropriate dietary modification can cure the problem.
M.A.M. (consultant nephrologist), London Wl A. Despite the fact that my correspondent of 4 March gave no indication of the body odour in question being ‘fish-like’, readers will join me in being delighted by your learned advice. Knowledge that this condition exists provides an invaluable opening gambit for tackling the tricky topic when offensive smells are being given off, e.g. ‘Good Lord! There’s a faint smell of fish from you — no, no, no, it’s not offensive — it’s rather pleasant. But could it be that rare disease trimethylaminuria?! Perhaps you should have a blood test.’
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