Farewell Tribute to MSN Body Odor Forum Times

As the month of February approaches, we can only sit and wait for our former MSN Body Odor Forum site to shut down. We now have our new forum, http://www.bodyodorsupport.com/, that we call home created with much love by Kristen and Matt.

Nonetheless, it is with a great deal of warm sentiment that I recall those special days in which we poured our hearts out to each other and lifted each other up out of the darkness that engulfed our lives. With each key stroke we shared our experiences, our trials and errors, our despair and our hopes with each other in an effort to help each other. By doing so, we became as close, or even closer with each other than most do with their own families. We began to share our pictures by posting them more and more in this site, and some later migrated them to ‘Multiply’.

As a tribute to this precious moment in time that we’ve shared as a community, I made a video of these pictures, paintings, and collages. I wish I could have posted this video in our new forum, but that aspect of our forum has not yet been developed. So, it is posted in my blog, and I do hope you enjoy strolling down memory lane with me.

We have built so much together, let’s keep the flame burning. We’ve only just begun the healing process, and there is still so much more to do!

I do hope you enjoy this video…

Some extracts on FMO enzymes in books via googlebooks

The Flavin Mono-oxygenase 3 enzyme is said to be flawed in a diagnosis of Primary Trimethylaminuria (despite anecdotal test results of DNA suggesting otherwise, and also a dissertation where 8/12 had no mutants/variants). The enzyme deals with a lot of odorous substrates; sulfides and amines and phosphorus compounds. As textbooks currently say, since these other compounds are thought to be able to go a slower complex alternative route, via the P450 enzymes, (P450 and FMO are regarded as a layer of oxidizing activating/detoxing enzymes - the phase 1 enzymes) the other sulfides and amines aren't regarded as un-oxidizable as trimethylamine is. Perhaps this enzyme will turn out to be the main 'smelly' enzyme and perhaps the problem is to do with a backlog of these substrates. Trimethylamine doesn't seem to explain fecal body odor, whereas other sulfides and amines seem plausible.

For this reason, it is probabably useful to know about these enzymes, and in particular, FMO3. This is a good extract from a 2003 Molecular Toxicology book about the FMO family of enzymes.

Molecular Toxicology By Nick Plant: FMO

This chapter is from a 'gold standard' 2001 medical book on toxicology, the chapter dealing with the xenobiotic metabolizing enzymes (aka drug metabolizing enzymes, first pass enzymes, phase1/phase2 enzymes).

Casarett and Doull's Toxicology: Biotransformation of xenobiotics

1999 Research paper on hydrogen sulfide and methanethiol in the cecal mucosa

1999 Paper

Detoxification of hydrogen sulfide and methanethiol in the cecal mucosa.

Levitt MD, Furne J, Springfield J, Suarez F, DeMaster E
Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA

The acute toxicity of H2S and CH3SH appears to result, like that of cyanide, from the inhibition of cytochrome oxidase. In vitro measurements have shown that H2S actually is a slightly more potent inhibitor of cytochrome oxidase than is cyanide
Note: This introduction is the opinion of the author, and may not be wholly accurate

This group of researchers in Minneapolis seem to have done a lot of work regarding sulfides in the gut and their absorption. At the moment it is unknown as to if or how dysbiosis may relate to metabolic body odor, especially fecal body odor, but it would seem that chemicals produced in the gut will be responsible for many of the smells of fecal body odor, including sulfides.

Whilst the liver plays the main role in detoxifying circulating toxins, it also makes evolutionary sense for these type of detoxifying enzymes to be available where sensibly needed, such as the gut. These will often once again be of the xenobiotic-metabolizing enzyme variety, in what is known as part of the the 'first pass metabolism'. That means any absorbable toxins in the gut could be detoxified on-site, but if absorbed they then have to get past the liver, before getting into the systemic circulation. It's known that the P450 enzyme, 3A4 is present in the small intestine, for instance.

All the papers to do with the gut and metabolism by the above researchers are interesting. In this case, they look to see how hydrogen sulfide and methanethiol are metabolized in a rats cecum. These two compounds are likely present in the human gut, probably generated from sulfate reducing bacteria (?) feeding off sulfur in the colon. Perhaps some with fecal body odor have found they can smell of rotten egg when their recent diet has included poorly absorbed sulfurs. We can't be sure why this would be, but this could be one theory.

They expected the route of detoxification of the compounds on-site in the colon (by the colon lining cells, presumably) to be:

H2S methylated to methanethiol which would be altered to dimethylsulfide.
Instead they found methanethiol was demthylated into H2S which was then oxidised to thiosulfate

Their interest was because it has been proposed that these compounds may be implicated in ulcerative colitis. They will be unaware of fecal body odor.

Of note is that the researchers find that both compounds have an inhibiting effect on the cytochromeP450 first pass metabolism enzymes, apparently stronger than cyanide does.

Pubmed abstract

Full paper

Metametrix slideshow of case study of patient with dysbiosis and leaky gut

Metabolic body odors like fecal body odor syndrome currently are not defined, but it seems very possible in many cases there may be a dysbiosis factor. Perhaps just general dysbiosis, or maybe a certain unique type of dysbiosis.

This case is an interesting use of Metametrix' tests. It should be kept in mind the physician did not seem to be part of Metametrix staff, and the treatment in this case may or may not be the best way for body odor conditions. It is posted rather as an example of the power of testing when trying to define and monitor health problems, rather than blind supplementation. The case study itself is not intended as general advice.

Metametrix slideshow by Eve Bralley: 52 year old patient with dysbiosis and leaky gut

Metametrixinstitute.org

Phoning the Body Odor and Halitosis Conference Calls from overseas : The cheapest ways

One thing that may put internationals off phoning the USA based body odor and halitosis conference calls is the cost. Usually the dearest way is by using your supplier and calling direct. One way of avoiding expensive costs is to use prefix 3rd party call operators (call overriders). There are many of these companies. Some you need to register (online) and some you don't need to join (it's put on your phone bill). Either way, the call will likely be substantially cheaper than going through the direct main supplier.

For instance :
UK to USA using BT : 18p per minute
Using a prefix company : 0.5p per minute

There are also internet call services, like Skype, which may be normally not as cheap as the prefix call companies, but still much cheaper than direct calling.

Note: If registering with a prefix company, make sure there are no major catches. Ideally, you wouldn't need to join the company and only have to dial their long prefix and it appears on your usual bill, or you can register online and set up a direct debit and dial their prefix. With most companies, you only want to use their number when you want.

Orphanet and list of potential contacts for trimethylaminuria help

Perhaps if anyone enquires by email, they may agree to do testing. Adult Metabolism Units would seem natural first choices of contact.While it is very difficult to find known testers of metabolic body odors and/or halitosis, the technology is probably readily available worldwide in, for example, hospitals. Detection of the smelly compounds probably being possible using a gas chromatography/mass spectrometry machine or by Proton NMR spectroscopy or similar. These are usually present in metabolism units in hospitals, usually for pediatric units or adult metabolism units.

With something like trimethylamine, it's presumably a case of them calibrating the GS/MS to look for that. For those who feel trimethylaminuria doesn't seem a sole answer, they could possibly be tested for any volatile organic compounds rather than just trimethylamine, or just malodorous volatile compounds.

Orphanet seems to be a European based website giving information on health problems and possible connections. In their section on TMAU, they have a list of 'clinics' and 'diagnosis centers'. On first glance most don't seem to list trimethylaminuria, (although more do than expected), but they all seem to be metabolism units of some sort and will have the technology. Usually they use them to detect amino-acid disorders or organic acids. Perhaps if anyone enquires by email, they may agree to do testing. Adult Metabolism Units would seem natural first choices of contact.

These links (and the ones in the sidebar in the section : "Peer Evidence for Experts") may be helpful in persuading them about trimethylaminuria and it's prevalence :
www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&partid=1103
http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=35056

---

Listed contacts for trimethylaminuria on Orphanet
Orphanet trimethylaminuria link : clinics
Orphanet trimethylaminuria link: diagnosis

2003 paper: Biofilms and the tongue: therapeutical approaches for the control of halitosis

2003 paper:

Biofilms and the tongue: therapeutical approaches for the control of halitosis.

Roldán S, Herrera D, Sanz M.

Faculty of Odontology, University Complutense, Plaza. Ramón y Cajal s/n, 28040, Madrid, Spain.

Methanethiol (also known as methyl mercaptan) is a colorless gas with a smell like rotten cabbage . It is a natural substance found in the blood , brain, and other animal as well as plant tissues... It is also one of the main chemicals responsible for bad breath and the smell of flatus. The chemical formula for methanethiol is CH3SH ; it is classified as a thiol.
Wikipedia
The dorsum of the tongue seems to harbour one of the most complex microbial niches in human ecology, sometimes resulting in halitosis. One of the main chemicals responsible for bad breath and the smell of flatus is methanethiol (also known as methyl mercaptan).

In addition to diagnosing and managing possible metabolic condition causing alveolar halitosis, one would also need to address the need to control this bacterial niche. Different home remedies that some sufferers claim have shown positive results include the use of a tongue scraper, applying drops of lemon juice toward the back of the tongue, gargling with a mild saline solution with baking soda, and nasal wash with a Neti Pot, amongst others. The following study explores the effects of various antimicrobial agents.

...little is known about how to control this bacterial niche, and factors affecting tongue coating composition and aspect are not fully understood. Studies available on the influence of mechanical or antimicrobial approaches against tongue biofilm are very limited. Mechanical treatments showed a transient reduction in halitosis-related variables but were limited in time. Different antimicrobials agents have been evaluated: chlorhexidine, chlorine dioxide, metal ions, triclosan, formulations containing essential oils , and hydrogen peroxide. However, most studies were designed as short-term models. Some of these studies demonstrated that the reduction in halitosis-related variables was associated with significant changes in the tongue microflora.

Abstract on springerlink.com

Wikipedia : Methanethiol

Poll: Bloodborne body odor : If you tried chlorophyll, did you feel unwell at first ?

Bloodborne Body odor : If you tried chlorophyll, did you feel unwell at first ?

1999 paper: Differentiation of mouth versus gut as site of origin of odoriferous breath gases after garlic ingestion

1999 paper :

Differentiation of mouth versus gut as site of origin of odoriferous breath gases after garlic ingestion

F. Suarez, J. Springfield, J. Furne, and M. Levitt

MALODOROUS BREATH (halitosis) is a common problem that has received extensive study (2-5, 10-12, 17-19). Virtually all of these studies have worked on the assumption that the malodorous compounds originate in the mouth (2-5, 10, 11, 17-19). However, there is abundant evidence that gases produced by the microflora of the gut, such as hydrogen and methane, are efficiently absorbed into the portal blood flow and then excreted in expired air (7). The extent to which odoriferous breath gases are derived from the mouth versus the gut has not been rigorously investigated. This differentiation is of importance because cleansing of the oral cavity would not be expected to appreciably reduce the breath concentration of gases derived from the gut.
http://ajpgi.physiology.org/cgi/content/full/276/2/G425

Many people who feel that halitosis is their problem in our community are unsure if it's oral based or metabolic. Traditionally, metabolic halitosis has not been considered. Recently, because of trimethylaminuria, the few papers on that subject include the notion of trimethylaminuria halitosis.

In this paper, from 1999, they consider it the first looking into the concept of metabolic halitosis by provoking it with the consumption of garlic, which is commonly known to cause smells. For anyone who hasn't thought of the principle of metabolic odors before, another obvious example would be drinkers having alcohol breath and perhaps hours later having alcohol body odor too. This is basically consumption of so much alcohol that it is circulating freely in the blood. Another example would be those who get 'curry body odor' after eating a curry.

The results of this study demonstrate that halitosis may be of oral and/or gut origin. A rational approach to the treatment of this common problem presumably should begin with the identification of the malodorous gas and its site of origin. The simple techniques utilized in the present study make it possible to differentiate between a mouth versus gut origin. In the paper, they investigate where the garlic smells are coming from. They test the mouth breath, and the alveolar breath (breath from the lungs), and urine. Mostly, the compounds that turn up in their results are detected from the mouth breath largely, apart from allylmethyldisulfide (AMS), which turns up later in the urine. Through work they have done on rats, they have discovered that this isn't easily metabolized by rats or humans. They conclude that the other odorous compounds found were quickly metabolized when absorbed, and so didn't show in alveolar breath or urine in significant size. They used 'normal healthy' volunteers for testing. It may have been very different if they used metabolic body odor patients.

Currently, any expert interested in trimethylaminuria will likely only test for TMAU. It would be interesting to see how someone with a weakened FMO system coped with these Volatile Organic Compounds (VOCs) found in the garlic test, since most of them are likely FMO substrates. It seems ironic that those who are burdened with metabolic body odor are only offered the TMAU test whereas in the other tests done on pubmed they seem to test for all VOCs to see what turns up. Perhaps someday the metabolic body odor and halitosis test will be a blank check of VOCs, rather than just one compound.

The researchers in this paper have been involved in much research to do with compounds and concepts that are likely of interest to metabolic body odor and halitosis sufferers

Hair testing

When metabolic body odors and metabolic halitosis finally get attention from the health system, stage one will be trying to define what the problem is through testing. The technology is probably readily available in labs across the countries (say, at metabolism units in hospitals), it's a case of getting them to test for the metabolites (in the way that a very few test for trimethylamine).

"Drug and drug metabolite(s) are incorporated into the hair matrix from the bloodstream following drug use. Hair drug testing detects drugs that are embedded in the hair"

Labcorp site
Once that stage is reached, it's a question of how to test the patient. There are a few various ways. The most obvious would be testing for volatile organic compounds in urine, blood or breath. Another new(ish) way of testing is from hair samples.

This post is about hair testing. Currently drug and alcohol detection labs seem to use the various ways to detect drug/alcohol and are the most obvious labs on google searches of "hair testing". It's unclear if the health-system 'advisors' back their claims.

Taking the labs claims as accurate without question, the advantage of hair testing seems to be that it can detect compounds accumulated over days/weeks. Unfortunately no-one tests for likely 'smelly' compounds currently. A 'metabolic body odor' profiling test. Some check mineral status. Hair testing would be no use as 'spot tests'. For trimethylaminuria, first thoughts are that it would maybe be able to detect trimethylamine, but not trimethylamine-oxide.

Overall, the concept sounds useful but it's unknown how accurate the method of testing is currently regarded.

---

random links :
wikipedia : hair testing
Labcorp hair-testing lab for drug/alcohol detection
Pubmed 2001 paper on hair testing
Letter of reply from a lab re the Pubmed paper
Society of Hair Testing

Why can't body odor and halitosis sufferers and their 'loved ones' often not smell anything ?

One of the mysteries about body odor and halitosis, whether it is a surface problem or metabolic, is how so many can go around with body odor (or halitosis) apparently unaware of it, and also how often their 'loved ones' (whether genetic, or partners, or close friends) swear they can never smell the sufferer.

Sufferers have many theories about this, and at this point it is anyone's guess. Here are a few possibilities for now:

1: Some genetic or 'practical sensitivity gap' aspect. For instance, say the body odor is metabolic, perhaps some people with a similar enzyme flaw cannot smell sufferers. If not because of a genetic reason, then perhaps certain people have the same toxins circulating in their main system, and there's not enough of a 'sensitivity-gap' for them to detect sufferers. Or else their smell receptors for these smells (perhaps only via the skin/breath) are often near to saturation. This point is made because most sufferers seem to not have a problem in smelling normal smell fecal/gas smells. It is too complex to come up with one theory on this aspect, but it seems a very possible theory. This could not only apply to metabolic body odors, but to external body odor too. When you think about it, why do so many people who have 'washable' body odor not have someone (for instance a parent) to tell them 'you should wash' ? You have to think that not all their loved ones are heartless/too embarrassed to tell them. If a son/daughter/sibling/partner smelt sometimes of a body odor that they could wash off, would you not tell them ? There are still many hygienic people who go around with classic washable external body odor. The same seems to likely be true for both types of halitosis. If someone has permanent classic 'local' halitosis, why doesn't a 'loved one' tell them ? Perhaps because they can't smell them ?

2: Another theory mentioned is that people (sufferers and 'loved ones') get used to the smell. They perhaps become desentsitised to the odor(s), as one does with the fragrance in soaps or detergents, for example.

3: Perhaps most don't smell all the time. This seems likely for most, and also complicates diagnosis further, perhaps tying in with option 1. In Dr Pretis et al's 2007 paper Human breath odors and their use in diagnosis, he mentions that in the small TMAU group in the study, he could not smell any before the choline challenge, and only the 2 very 'low %' after the choline challenge. However, smelling of fecal or gas smells 1% of the time, when you don't know when you smell or the pattern, it's going to affect the sufferer's psyche 100% of the time. It seems possible that sufferers perhaps smell for certain minutes/hours at a time, or sometimes spontaneous for a few minutes. It's unclear at the moment. If the two factors were to do with how much enzyme someone had and how bad the 'smell' dysbiosis was, then someone at the top-end of each factor could smell more often than others. In that case someone only with the 'smell' dysbiosis could smell more often despite being 'normal'. But who knows.

There are probably many other theories which will be added as time goes by.

It is one of the most frustrating aspects of the problem, but in a strange way, since some people can't seem to smell sufferers, may be a cruel blessing for some, until the area of body odor and halitosis is properly researched. Especially the unknown metabolic body odor area. Perhaps it's a case that those suffering the same type of body odor or halitosis cannot smell each other. When Tammy Gobin (TMAU) went on the Tyra Banks Show, she later said in a Yahoo TMAU forum post that she could smell the lady on the show who claimed to have halitosis. Perhaps the other lady had a different type of odor problem, and so there was a clear 'detection sensitivity-gap'. However, so far at meetups everyone seems likely to be 'smell free/normal' for those few hours. And also perhaps smell-free within a certain unknown % of the population (perhaps as much as 15% ? more ?) at all times.

If it was to do with some sort of metabolic body odor or halitosis problem, it seems very possible that even 'carriers' of the flawed gene will not be able to smell sufferers. And neither will fellow sufferers. this seems to be confirmed by the feedback from body door and halitosis 'meet ups' - nobody smells anything even around people diagnosed with TMAU, with the exception of only a few passing occasions. So at least amongst this group (sufferers and carriers), someone with a metabolic body odor problem is likely to be 'smell free' to another sufferer, even if they are smelling at the time. On the upside, this means dating and friendship amongst this group would most likely mean 'no smells'.

There was a scientific paper in 1975, that found among a group that 7% could not detect trimethylamine. You can read the full document in PDF on that page
http://www.springerlink.com/content/l1hnv449m7267321/

Sufferer's website of body odor theories : Bodyodor777.com

Everybody has body odor, some more than others. This website is for those who have strong, chronic body odor and are trying to find an end to this torture. I have compiled my research in this web to help as much as possible. There is no definite remedy for everybody, but the concrete information in this web will facilitate your search to find a cure.This website, bodyodor777.com seems to be run by a sufferer trying to make sense of the maze of body odor (which as anyone with the problem knows, for the vast majority of sufferers is far more complex than society thinks). They have gathered their own ideas as to possible theories. It presents an interesting general overview of internal and external causes of strong, chronic body odor. Of particular interest is the Internal Causes section that in addition to the ones normally come to mind related to metabolic disorders, hormones, mouth, nose, throat, and intestines, it also discusses sources such as the gallbladder, kidneys, allergies, liver, food intolerance, acidic body, anorexia nervosa, and more.

http://www.bodyodor777.com/index.html

Monitoring Metabolic Status and Disease Recognition

When reading the section of this book entitled, ‘Messages in Body Odor’ written by the Institute of Medicine of the [US] National Academies, it brings to mind that it might be precisely the analysis of our odor that would lead the experts to diagnose the causes of our body odor condition. The section, ‘Disease Recognition’ discusses how dogs and mice’s sense of smell can detect metabolic diseases such as diabetes, scurvy and gout.

This book also discusses two studies that investigate the ability of humans to communicate emotions, or psychological state, through body odor. It also points out how the use of body odor emits chemical signals that can be used to recognize the individual identity of other members of the same species.

Throughout history physicians have used body odor to diagnose metabolic diseases (e.g., diabetes, scurvy, and gout) and infectious diseases (e.g., smallpox, typhoid, and yellow fever) (see Penn and Potts, 1998a). There are also anecdotal account of dogs’ abilities to detect human skin cancers before overt symptoms of the disease were present (Church and Williams, 2001). These observations need to be confirmed with rigorous experimental study.

Nevertheless, female mice could discriminate between parasitized male and healthy males (Kavaliers and Colwell, 1992) and showed less attract5ion to the odor of male mice infected with intestinal parasites than they did to healty controls (Kavaliers and Colwell, 1995)…

Yamazaki and colleagues (2002) studied the ability of mice to discriminate the urine odor of other mice experiementally infected with mouse mammary tumor virus (MMTV), a B-type retrovirus that is tightly linked to immune responses…

books.google.com: Monitoring Metabolic Status By Institute of Medicine (U.S.). Committee on Metabolic Monitoring for Military Field Applications, Institute of Medicine

Juror dismissed for body odor

This 2006 Boston court case was recently the case of an appeal and typifies what a handicap body odor can be. The appeal was because a lady juror was dismissed for her body odor. It doesn't say what the lady smelt of, but metabolic body odor must be a possibility. It goes to show, at the very least, that society should legally make non-washable body odor a disability.

Prior to the jury being given the oath, the judge dismissed the juror and subsequently made the following findings on the record: "There was a juror seated in seat No. 10, juror 6-5, . . . who I'd made inquiry of earlier. And I just want the record to reflect, I guess, to be blunt, [the juror], for whatever reason, had some very bad, I guess to be blunt again, body odor, which was extremely strong, and I was able to detect in my lobby, as was the clerk, which is a personal matter for that potential juror, but for the fact that her personal problem was [of] such a magnitude that other jurors who had already been picked . . . either by act or words had indicated discomfort with that problem." The judge then addressed the defendant's objection to the juror's removal, stating, "my concern is not her background, but rather that I have [sixteen] jurors who are able to function. And given the strength of the body odor, I'm satisfied that the other jurors would be put at a distinct disadvantage in their efforts to concentrate. So I note your objection, but she has been excused."

http://www.sociallaw.com/slip.htm?cid=18729

The defence attorney said he smelt nothing

Bourbeau says he noticed no odor emanating from the juror. "The report came from the court officer," he says. "There was no note from other jurors."Boston attorney Michael C. Bourbeau, the defense attorney at trial, tells Lawyers Weekly that he found the juror's removal "very offensive. I was very opposed to it; I thought she was a good juror. Everybody should have the opportunity to participate in jury duty."

Bourbeau says he noticed no odor emanating from the juror. "The report came from the court officer," he says. "There was no note from other jurors."
http://www.dolanmedia.com/view.cfm?recID=450150

Join our new forum especially created for our community

Kristen and Matt have so kindly created a fantastic new forum just for our community. http://www.bodyodorsupport.com/. We have yet to get our logo and name up on this site since it is still being designed, and Matt is still working on the fine tuning part to make it even better for us.

Only a couple of months ago, MSN announced that all their MSN Groups service will close in February 2009. Arun Nagrath got us a 10-year subscription to our new site, and it will not have any advertisment on it. Matt and Kristen have dedicated endless hours creating it for us, and have done a extraordinary job.

We don't want to wait until MSN closes its doors on us, we are migrating before they do. Please come and join us in this new site and check it out. Register and join our community to communicate and participate with us in future fundraising and research endeavors. We would love to hear from you. By registering, you will be coming to the right place where we offer you camaraderie, support, and where we learn from each other not only how to manage our body odor condition at a physical level, but also at an emotional and social level.

Here we discuss what has worked for some to minimize or control our odor, but most importantly, we also work on building close ties of friendship to lift us from isolation. Everyone is welcomed, and everyone is special in his/her own unique way. So please feel free to participate in our forum, in our free phone conference calls, and research efforts, all announced in this new forum site and in this blog.

Hope to see you at our new forum!

Women's Conference Call topic of discussion: treating vaginal odor

Our Women’s Conference Call yesterday was primarily about medical treatments prescribed by our gynecologists and remedies that have worked for some of us with vaginal odor. Women who suffer from a body odor condition in which volatile organic compounds (VOCs) are found in their blood and released through their breath, their skin through oils and perspiration, urine, and vaginal fluids seem to develop a secondary condition involving a very alkaline vaginal environment that is conducive to a microbiota imbalance.

As we have discussed in the past, a metabolic BO sufferer’s usual body odor is heightened before and during menstruation as a result of the hormonal changes that take place at this time of the month. After consulting with their gynecologist, some women have opted to use Depo Provera (medroxyprogesterone) injections to almost completely eliminate or completely eliminate ovulation and menstruation. With this hormonal treatment, women are able to forego the more odorous time of the month because in addition to preventing ovulation this hormonal treatment also changes the cervical mucus and uterine lining.

For this same purpose, some women have also taken Ortho Cyclen (ethinyl estradiol and norgestimante) under their gynecologists’ care. This combination of female hormones prevents ovulation resulting in changes in the cervical mucus and uterine lining.
Some of the VOCs, such as trimethylaminuria (TMA) are very alkaline (have a high pH). When the pH is not balanced at or around 4.5, an overgrowth of certain microbiota in the vagina may occurs, thus yeast or bacterial (gardnerella) infections may develop. See post in this blog entitled, ‘Non-infectious and infectious causes of vaginal odor'.

Due to the close proximity of the urethra to the vagina, bladder infections may also develop. Both need to be treated together or they will continue to contaminate each other resulting in a long term condition. Some gynecologists have prescribed Aci-Jel (Acid Gellant) to some of the ladies, which is a bland non-irritating, water-dispersible, buffered acid jelly for intra-vaginal use.

Due to the close proximity of the urethra to the vagina, bladder infections may also develop. Both need to be treated together or they will continue to contaminate each other resulting in a long term condition. Some gynecologists have prescribed Aci-Jel (Acid Gellant) to some of the ladies, which is a bland non-irritating, water-dispersible, buffered acid jelly for intra-vaginal use. Aci-Jel has a pH of 1.6 and lowers the vaginal pH to 4.5 when used every 3 days. By stabilizing the vaginal pH, a healthy microbiota balance can be maintained.

One of the women on the call was concerned about the fact that Aci-Jel contains egg albumen (egg whites), and wondered if it would be high in choline, and we had a discussion about egg whites not being high in choline, but instead the egg yolk is high in choline. In addition, the amount would be very small, and we were not convinced that it would permeate into the bloodstream, so we felt that it should not contribute to the odor. Nonetheless, women who have sensitivity to egg products should consult with their physician before using this prescription medication.

In addition to the above-mentioned prescription medications, we discussed the benefits of a probiotic specifically designed for women, called Fem-Dophilus® from Jarrow. As far as we know, it could only be purchased only online.

After all this discussion, we reiterated to each other the importance of a proper diet to control the VOCs in our blood that in addition to producing odor, may also be altering our vaginal pH resulting in odorous infections as well. We also strongly emphasized the importance of consulting with one's gynecologist before undergoing any hormonal treatment or using any prescription medication.

About metabolic body odor

Introduction to the concept (to be updated/edited as and when):

Metabolic body odor, or systemic body odor or bloodborne body odor. They all have the same outcome.

They mean odorous compounds are circulating in the main circulation for some reason.

There can be a number of reasons for this. Some examples would be :

Some weakness in a (most likely, Hepatic) cell enzyme that neutralizes odorous compounds, allowing the compounds to enter the main circulation

Overload of odorous compound(s), causing 'untreated' compounds to circulate in the main system (same outcome as above). An obvious example of this would be that some people smell of curry after eating curry meals.

Perhaps a combination of both

Possibly these are the 3 main reasons, but nobody probably knows. most people with this problem seem healthy apart from smelling, so liver problems seem unlikely.

The only 2 'accepted' 'benign' examples of metabolic body odor probably are
1: Trimethylaminuria
2: Dimethylglycinuria (one pubmed paper)

It's likely that these 2 may not be the only types of metabolic body odor. Many people mention smelling fecal or gas or sewage or various spectrum's of smells. Trimethylamine wouldn't seem to explain all these various smells.

Only TMAU is occasionally investigated by a handful of researchers around the world. You could say the problem is quite neglected. Geneticists estimate perhaps up to 1% could be 'at risk' of poor FMO3 function. It's told to anyone interested that it's an autosomal recessive disorder, but some studies are casting doubt on this too.

At this point, there are those diagnosed with TMAU who believe this is their sole problem, so they at least have a diagnosis and treatment protocol. For the rest, currently we don't have any diagnosis, and this is the stage we are at.

It's probably best the community empower themselves to create research and awareness, rather than rely on anything currently and in the future offered by the system (for those few that are even aware). Probably a lot more could be done.

Fecal body odor/Gas body odor
Special mention is given to these types of body odors, which seem to be 'intestine-derived' body odors, where the smelly chemicals somehow seem to be circulating in the main bloodstream. In theory some smells may be 'internally' (endogenously) produced. For instance it's now known hydrogen sulfide is produced in the main system (as a 'gasotransmitter'). But most of the smells would seem to be obviously sourced from the gut. At the moment this is an unknown disorder to the medical system, but seems to be the most common form on body odor forums. For any experts who think it's impossible, again the 'curry meal' principle seems to disprove this. As with trimethylaminuria (which is also intestine sourced), the obvious starting points to a theory are that for some reason there is an inefficiency in the 'filtering' process (the liver , mostly. Most likely to do with one or more hepatic cell enzyme) or that there is a large abnormal dysbiosis of the gut flora, which leads the a large amount of the smelly chemicals in particular being produced (or else it is a unique particular dysbiosis with this condition). Or perhaps a bit of both. At the moment it is anyone's guess.

Please join us on our first 2009 Women’s Conference Call today

Hello Ladies,

Please join Tisha and me on our first conference call of 2009 today at 8:30p.m. Tisha’s computer has a virus and she can’t write the announcement post this time, so I’ll do it in her absence.

It will be an open forum about our women issues, especially those we faced with our families, significant others, or by ourselves this holiday season. In addition, we can also talk further on the topics discussed this past Sunday as noted in the blog below entitled, 'Our first Conference Call of 2009', such as our migration to our new forum, invitation to create personal mini-blogs in Multiply, Pending publications, and the establishment of a Charity to fund research.

I hope to see you ladies there. We have so much to discuss!

María

Anthology Update 4

Richard sends us his 4th update on the progress of the compilation and publication of our anthology. I feel very confident that we will get it published sooner than later, but Richard wants to explain the whole process to us. Thank you Richard for coordinating this with so much attention to detail for us. You do a great job at keeping us updated. Even your updates sound like they're written by a professional writer - they're so enjoyable.

Picture: Tres Amigos, by Ben Rimmer

Everyone involved in this project deserves a pat on the back for a job well done: from Maria, the person who came up with the idea for the anthology; to me, the editor; to Ben, our artist; to all of the talented poets, essayists and story writers; to all of the members who gave their invaluable ideas for improving the book, and to all of the members who generously gave their permission to use their posted messages and replies. I applaud you all! ...

I’ll submit our manuscript to several regular publishing companies first: the ones that don’t require a fee to publish our book. I should hear from our first publishing company 2-4 weeks after they receive our work. If we are rejected by them, I will send our book to the next one until we have exhausted all of our efforts to get it published for free. At that time, we would have to submit the manuscript to a vanity publishing company: one that requires a fee for publication. In this case, we would have to raise anywhere from $500.00 to $800.00 to get our book published. Details on how we can all donate whatever we can will be included in a future update. Again, all of this will take place only if we are rejected by all of the free publishing companies we can contact. One way or another, our book will be published.

If anyone has any questions, please post it so that everyone else can see it. And I’ll answer it as best I can. Since messages disappear so fast on the General Board, I prefer that you use the Poetry/Stories Board to post your question(s). Answers will be posted on both boards.

I’ll post the final draft of the anthology sometime between Monday, January 19 and the 30th, several days before submitting it to our first publishing company. I want the group to see the finished product before the rest of the universe does. Maybe we’ll get lucky and aliens from other worlds will read it and beam us down a cure, or else beam us all up and take us with them. Hey, it could happen! I also need members to point out any mistakes I might have made before I submit the manuscript. But then, I don’t believe I’ve ever made a misstak in my life.

Rich

2008 dissertation paper on TMAU DNA : 8 out of 12 had no (known) mutations

http://digitalcommons.library.tmc.edu/dissertations/AAI1450285/

This January 2008 dissertation by Jaffar Alfardan poses a few questions regarding the trimethylaminuria diagnosis. Probably more questions than answers. Dr Alfardan has/had an association with the University of Colorado Denver Health Sciences Center (UCDHSC), which is where Dr Fennessey works. For a few years now, Dr Fennesseys lab has been the lab in the USA where perhaps 99.9% of USA TMAU urine testing has been done (mostly by mail).

The object seems to have been to match 12 'phenotype' (urine test) TMAU sufferers with the 'genotype' (DNA) test. Only 4 out of 12 matched this objective (TMAU = autosomal recessive disorder : 2 mutant copies). They also found a 'new' mutant amongst those 4, indicating how the current database of mutations is likely an underestimate, and how little research is done in this area. Amongst the other 8, some seemingly were double heterozygous for known 'polymorphic' FMO3 DNA copies. Polymorphisms are more common and are regarded as 'variations' in efficiency, rather than mutants that are severe. But there were even some with only one polymorph (E158K). Possible reasons for this may be that some/many mutants are still to be discovered, and/or that polymorphisms can cause problems ... and even that it may be an autosomal dominant problem if certain copies are involved (e.g. E158K).

Presumably no follow-up will be done on the dissertation.

...There are limited studies of the sequence variants causing TMAU in the literature with most studies describing only one or two patients and lacking genotype-phenotype correlations. Also to date, there is no laboratory in the US or Europe that offers TMA genetic testing on a clinical basis. We have recently validated genetic testing in the University of Colorado DNA Diagnostic Laboratory. We have a database of a few dozen patients with a biochemical diagnosis of TMA at the University of Colorado at Denver Health Sciences Center (UCDHSC) which includes a few patients with the classical form of the disease. We have used the newly established clinical test in our institution to attempt to characterize the genotype (sequence variants including mutations and polymorphisms) of classical TMAU patients and to establish a genotype-phenotype (biochemical and clinical) association. The questionnaire results confirmed most of the previously reported epidemiological findings of TMAU and also indicated that TMAU patients use multiple intervention measures in attempt to control their symptoms with dietary control being most effective. Despite the complexity of intervention, most patients did not have any medical follow up and there was underutilization of specialist care. In a set of our patients, two deleterious mutations were identified in 4/12 patients including a novel T237P sequence variant, while the majority of our patients (8/12) did not reveal any mutations. Some of the latter were double heterozygous for the E158K and E308G polymorphisms which could explain a mild phenotype while others had only the E158K variant which raised the question of undetected mutations. These results indicate that further experiments are needed to further delineate the full mutational spectrum of the FMO3 gene.

---

points of interest:

The 'textbook' explanation for trimethylaminuria would be it is autosomal recessive (2 mutations of the gene), but 8 of the 12 had no known mutations, and a new mutation was found. Polymoprphisms are usually regarded as being less severe and more common (more than 1% population), whereas mutations are often regarded severe and rare (such as null-allelle, where they are deemed almost useless), but the definitions are ambiguous. Perhaps the terms will make more sense as we learn more about DNA terminology. However, the main point here is that the 'textbook' explanation of trimethylaminuria being autosomal recessive wasn't strongly proven in this paper. The main problem for sufferers however, is that the dissertation was likely a one-off, and no further research is likely forthcoming on this subject in the near future. So the 'rare problem' tag will likely be around a while. Probably the best approach is for sufferers to become the motivator of research and awareness amongst decision makers, rather than the current situation.

Mutations and polymorphisms explained
Genetests.org glossary : double heterozygous

Our first Conference Call of 2009

We held our first bi-monthly conference call of the year 2009 today and much was discussed about our goals and expectations for the upcoming year. The topics discussed were the following,


*Migration to our new forum
*Invitation to create personal mini-blogs in Multiply
*Pending publications
*Establishment of a Charity to fund research

Migration to our new forum

In this call, we discussed at length our upcoming migration to the new forum with all its new features. Some of us went to see it and were very pleased with this new forum that Kristen and Matt created to try to meet our needs as prescribed by Arun. The speed with which this forum has been built due to time constraints is indeed impressive. It was so impressive that it turns out that a few of us rushed to register before it was ready and open for registration.

Since our three-hour long chat Arun, Kristen, and I held yesterday in the forum’s chat room, I suggested to the group that we hold bi-weekly chat sessions at this site so that our international and U.S. friends who can’t afford to join us in our conference calls could do so in this setting. This will only serve to bring us all more together. The idea was received very enthusiastically, and these chat sessions will begin as soon as the forum is opened to the whole community.

Kristen has informed us that the photo gallery section has not yet been completed, but photos can be posted within a post. We currently have the opportunity to store our photos, videos, and personal blogs in Multiply, and link to them from our new forum for now.

Invitation to create personal mini-blogs

After having finished writing poems, essays, and short stories for our anthology, Glenna suggested we initiate a new project to raise social awareness by organizing a social awareness campaign to educate the public of our condition and its negative social implications. Each member of our community is therefore encouraged to create his or her own personal blog, or mini-blog, in Multiply making it as unique as each individual in our community is unique, in an effort to give us an opportunity to communicate whatever we think is important about our condition to each other and to the world.

There is no prescribed format to follow and no need to limit ourselves to any specific topic or style. We can continue our literary expression in our mini-blogs as we did in our anthology. We can either take the personal approach as Kristen http://www.kristenjugueta.com/ and Olive http://copperolivegreen.multiply.com/ did with their respective blogs; or we can take a more scientific approach as we originally did with this blog liking to scientific articles.

Your personal blog can evolve as you evolve in whichever direction you want, as ours did by also becoming a community organizing support site of meet-ups and conference calls as well. Of course, pictures and photos, whether of ourselves, interesting places, YouTube videos, or media clips are encouraged in personal blogs, as a picture says a thousand words. In addition to our anthology, the more blogs are created by sufferers, including mini-blogs, the more information we will have at our disposal to work with in our social awareness campaign.

Pending publications

There are two publications in the works, our anthology and an inspirational book written by our own, Glenna Gonzalez. If Glenna writes as well as she speaks, I’m certain that her book will captivate the readers and take them on a journey.

Establishment of a Charity to fund research

Our discuss then shifted to the organizational effort of our charity fundraising and research effort for 2009. The objective of establishing a non-profit organization is to promote and raise funds for scientific and medical research of the causes and treatment of metabolic disorders and conditions and secondary causes of localized and generalized body odor disorders and conditions in order to find a cure.

Due to limited funds, we begin with the establishment of a Limited by Guarantee Company in the UK, http://www.sfsgo.com/guaranteecompany.asp#1#1, which will cost £195 (approximately $295.00/U.S.), including the yearly services of a Company Secretary. Our long-term goal is to establish a Charity in the UK, http://www.charitycommission.gov.uk/, which will cost £1,000 ($1,510.00) to £1,500 ($2,265.00). Our long-term goal is to extend this Charity to an international level with branches or affiliates located in many countries of the world.

Once the Limited by Guarantee Company is established, a business bank account with HSBC will be opened, and a PayPal account and linked to the company website and my blog in an effort to fundraise. The proceeds of our anthology will be deposited in this charity bank account. Since we don’t expect the initial donations to be substantial at first, we hope to be able to organize research at a smaller scale funded by the non-profit company. As we grow and enough funding is obtained to register as a Charity, we will then pursue a more assertive fundraising campaign for sizeable research grants from various governments and private Foundations.

We have many goals to fulfill by the end of this year. In December of 2009, we will again take pride in our accomplishments as we did this past December of 2008.

Join me on today's Conference Call

Hello everyone,

Please join Cabel and me today at the conference call at 2:00p.m. See the details on the center sidebar of this blog entitled, ‘Regular FREE (long distance call plan) General and Women-only Phone Conferences’ for details. (712) 432-1620, access code 391629#.

We can touch base on all the new things happening this New Year 2009, such as the migration to our very own new website, upcoming meet-ups, the charity I’m hoping to have up and ready by the time the anthology is ready for sale to fundraise for research. We have some research ideas that we can start with once the charity is up and we raise funds. Give us some ideas of the type of research you would like to see. Let’s brainstorm.

Join us everyone, it will be fun! Let’s hear everyone talk. Remember that you can always join us as a listener if you prefer, however, it would be nice to hear new voices!

María

$15 halitosis breath-tester at the 2009 CES Vegas conference

At the lower end of the breath analysis market, the sensors are normally MEMS Sensors (micro electro-mechanical systems). The cheap alcohol breathalyzers being examples. Some companies have also moved into the halitosis market, and have MEMs sensors that try to detect (usually) one or more Volatile Sulfur Compounds. There has been web mention of even Siemens putting a breath-checker in a mobile phone (but this was a few years back and no phone seems to exist yet). For many reasons the sensitivity and specifity of these halitosis checkers are currently questionable since we don't know much about them, but at least they are mostly very cheap.

One bad breath tester is on display at the Las Vegas CES conference. The Kiss-me-meter by Seju Engineering. Apparently $15 in Walgreens. There seems to be a few of these cheap-end testers on sale now. Dr Mel Rosenberg, the co-founder of ISBOR has one on sale called OK2Kiss by his company 'Innoscent'.

Perhaps you get what you pay for with these sensors. At the moment, scepticism seems a sensible approach. The Oral Chroma by Abilit seems to also be a MEMS sensor, but is expensive and used by professionals in a clinical setting. Hopefully the makers will find there is such a demand for such a product that the market will become as sophisticated as the alcohol breathalyzer market. Perhaps someday we can convince a maker to develop one that tests the breath for trimethylamine or other smelly compounds. Possibly for many metabolic body odor sufferers, sulfides will be part of the spectrum of smells, so in theory the bad-breath testers should overlap with the manufacturers target audience in that respect.

---

Seju-Engineering page on the CES 2009 site
Engadget article abut the kiss-me-meter
Seju Engineering Kiss-me-meter page
Siemens page about one of their top MEMS inventors
International Society for Breath Odor Research
Oral Chroma by Abilit

First UK baby screened for breast cancer gene born yesterday

This type of gentic manipulation seems to have started to come into use over the last few years, but in this case it was for a '%-risk' health problem.

It seems possible that if any gene was involved with metabolic odors, then future parents may have the opportunity to choose an embryo without the mutant/polymorphism DNA.

NewScientist blog article

FT.com article

concept: preimplantation genetic diagnosis (PGD)

Dr Michael Phillips Breath test talk at Pittcon 2009 Chicago, March 10

Breath Tests for Detection of Disease

Facilitator: Dr. Michael Phillips, MD FACP MRCP(UK), Menssana Research Inc
Tuesday, March 10, 2009 1:30 to 3:30 AM
Room N427A

Breathalyzers seem a promising way of detecting both local halitosis, and bloodborne body odor/halitosis as well. This seems to be an area of research picking up, largely because it is thought they may be able to detect many serious health problems early through breath, and also it would be very practical in a frontline clinical setting (The Drs surgery). One pioneer is Dr Michael Phillips of Menssana Research, who had a dream of such of a device for testing. His company has built a breathalyzer that can detect volatile compounds at 'parts per trillion'. He will be talking at the Pittcon Conference in Chicago this year.

...This session will address the technical challenges of detecting volatile organic compounds excreted in the breath in picomolar concentrations (parts per trillion), the statistical challenges of extracting a disease signal from a noisy background, the clinical challenges of designing human studies that will yield clinically useful new diagnostic tests, and the regulatory and financial challenges of bringing these tests to the patient and the doctor.

http://www.pittcon.org/technical/CNStemp27.html

Admission fee: The on-line registration price is $95 before February 9, 2009; $190 after.

It is posted in case anyone wants to go. He likely won't talk about halitosis. The Pittcon conference seems to be about spectrometers. Perhaps he will have a booth.

---

menssanaresearch.com
News video of Dr Phillips breathalyzer
Pittcon website

The phase 1/phase 2 biotransformation enzymes

Note: This is the author's interpretation of the article referenced below, and therefore, may not be wholly accurate

In our quest to understand bloodborne odor problems as best we can, this is another post about the xenobiotic metabolizing enzymes, also known as the drug metabolizing enzymes or biotransformation enzymes. This is the group of enzymes largely responsible for dealing with external foreign compounds, and altering them into something the body knows what to do with - in the case of toxins, turning them into water soluble non-toxic compounds. These enzymes also catalyze metabolic processes with internal compounds. They deal with compounds of similar structures.

At the moment, these seem like a natural parameter for looking for a 'metabolic' culprit(s) in fecal body odor and other 'non-specific' metabolic body odors. Other enzymes seem to be quite specific for certain substrates, and perhaps a sufferer will have a certain smell only, such as 'sweaty feet syndrome' with isovaleric acidemia. But at the moment this is speculation. We don't want to rule anything out, but this group of cell enzymes seem the first point of enquiry.

Xenobiotic enzymes are mostly situated in the liver cells, but are also present in cells anywhere the body, as the evolutionary process over the generations has deemed sensible. (e.g. the small intestine. Grapefruit juice can greatly inhibit CYP3A4 activity in the small intestine, but seemingly not the CYP3A4 in the liver). Phase1 seems to be enzymes that catelyses oxidation, reduction or hydrolyze reactions. Phase2 enzymes are known as 'conjugating enzymes'; they add a molecule to a compound to make it neutral and water soluble. For instance, in sulfation, a sulfur molecule is added.

The phase1/phase2 approach may not be commonly used, yet possibly still taught to medical students. Currently FMO3 is likely not given as much importance compared to CYP450 as is noted in the article, Flavin mono-oxygenase (FMO)--the 'other' oxidase, by an FMO3 expert (Mitchell SC in London). Some may see their point, since most with TMAU seem to be 'fine' apart from the smell. But other health problems may turn out to be associated. Such as chronic fatigue, or aggravation to other medical conditions such as neurological conditions (learning disabilities, anxiety, epilepsy, fibromyalgia, auto-immune diseases, etc.) . Only time will tell.

Medical students are likely taught that any 'deficiency' in a xenobiotic metabolizing enzyme is likely to do with a phase 1 enzyme, and that phase 2 are rarely deficient, but 5% (or more) of the population are estimated to have a weak 'glucuronidation' enzyme. This is regarded as usually 'benign' but testimonies on the problem seem to indicate differently. Often the sufferer will easily develop jaundiced, since this enzyme is greatly responsible for detoxing bilirubin. It's known as Gilberts Syndrome.

Hopefully the CYP450 article below will add to understanding these enzymes.

http://www.anaesthetist.com/physiol/basics/metabol/cyp/Findex.htm#cyp.htm

Secondary Trimethylaminuria explained

Keywords/concepts:
Primary Trimethylaminuria urine test (TMAU1)
Secondary Triethylaminuria urine test (TMAU2)
Trimethylamine-N-Oxide
Trimethylamine
Overgrowth of bacteria that produce trimethylamine
DNA test looks for known FMO3 mutants/polymorphisms. FMO3 DNA test.

---

Primary Trimethylaminuria urine test : This is a test of trimethylamine-n-oxide and trimethylamine levels after a (presumed) trimethylamine load of some sort (either choline or foods containing choline, relying on the gut bacteria to turn it into trimethylamine). FMO3 enzyme turns trimethylamine into non-odorous trimethylamine-n-oxide. In a normal person, about 91% or more of the TMA is expected to be oxidized to TMA-Oxide by FMO3 in the liver. There is no internationally agreed level at which abnormal levels are categorized, but as a guideline, one expert suggests :

TMAO x 100/TMA + TMAO = more than 90%
TMAO x 100/TMA + TMAO = 70% - 90% : implies 'mild' TMAU
TMAO x 100/TMA + TMAO = less than 70% : suggests 'severe' TMAU

Secondary Trimethylaminuria urine test : It seems secondary TMAU (TMAU2) is supposed to be all forms of increased TMA levels not to do with a genetic FMO3 deficiency, but in practice seems to be used to  label people with excessive TMA and TMAO levels who are also converting over 90% of the TMA to TMA-oxide. It usually implies they have an overgrowth of TMA-producing bacteria. If over 90 % conversion is reached, they seem to have a normal functioning FMO3 enzyme, but are producing so much TMA that the TMA and TMAO levels are very high and there is still enough TMA unconverted to produce a smell. This is to do with TMA concentration. Most labs do not seem to take TMAU2 into consideration in their results, with Sheffield Children's Hospital being an exception. Their current acceptable level of TMA is set at under 10.8. People can have both TMAU1 and TMAU2 (i.e. genetic TMAU and TMA overgrowth). Someone with only TMAU2 due to bacterial overgrowth should in theory be totally curable (by eradicating the bacteria overgrowth)  

Example of TMAU2 result :
TMA 20
TMAO 380
% conversion :  95% (normal)
TMA is over 10.8 (Sheffield level) so TMA smell still expected

Someone with only Secondary Trimethylaminuria would likely be advised not to do the DNA test, but at this point in understanding the problem a suggestion is to do the DNA test if possible if in doubt.

More information on TMAU testing

ISBOR bi-annual breath malodor conference in Dortmund April 26-30

http://www.isbor.net/

Note : The secretary said the public can attend this, but it is quite costly to enter the conference hall. See their website for details (and perhaps email to confirm)

The International Society for Breath Odor Research (ISBOR) is holding their 8th bi-annual conference in Dortmund on April 26-30. This year it will be a joint conference with the International Association for Breath Research (IABR).

ISBOR focuses on oral malodor, whereas IABR focuses on all aspects of 'breath analysis'.

It is of great interest to both bloodborne body odor and halitosis, as well as 'local' halitosis, because they focus their research on 'breathometers' that detect the compounds in breath. Perhaps someday there will be body odor (& halitosis) conferences too (with the emphasis on metabolic body odors)

The International Society of Breath Odor Research was created in Leuven Belgium in 1995 at the occasion of the second International Workshop on Oral Malodor. Indeed, inspired by the first workshop organized in Israel in 1993 by Mel Rosenberg, a second conference was organized by Daniel van Steenberghe and Mel Rosenberg. It gathered 140 scientists and clinicians from 16 countries representing everything from ENT to dentistry and from gastroenterology to periodontology. Since 1995, seven ISBOR conferences have taken place throughout the world including Herzliya 1993, Leuven 1995, Vancouver 1997, Los Angeles 1999, Tokyo 2001, London 2004, and Chicago 2007. The eighth ISBOR international conference will be in Dortmund, Germany in April 2009.

The aim of ISBOR, as defined in the constitution, seeks to "promote research and dissemination of research findings in all aspects related to breath odor." Until two decades ago, the knowledge of this very relevant social and health issue was limited, and its teaching anecdotal, ISBOR has been able to raise the awareness of and interest in the implications of breath odor for general health care. ISBOR represents a unique multidisciplinary gathering of people convinced that cross-fertilization is beneficial for the advancement of science and patient care.
http://www.isbor.net/about.html

---

http://www.isbor.net/
http://www.iop.org/EJ/journal/JBR
http://www.smellwell.com/aboutMel.aspx
http://www.iabr.li/

Main polls reset : You can vote again

Due to a bug in the blog, probably at the time of the domain name change, the main page polls were going backwards, which isn't very helpful when you are trying to convince experts of numbers of sufferers. Since it wasn't known how to sort this, it was decided to reset them and start again.

The top poll was around 290 originally, should now have been around 310-320, but instead was at 250 and decreasing.

The idea of the main polls is to catch the eye of any passing experts, and to make sufferers aware they are far from alone with odor problems. Especially fecal body odor or metabolic halitosis, which seem to be currently unheard of by most experts.

All body odor and halitosis sufferers are welcome to vote (again). The polls are anonymous with no way of knowing who voted what (apart from anyone physically viewing your vote in your own browser after voting. If this was an issue you would clear the cookie for this site in your browser settings after voting)

Update :
unfortunately the new polls also have the bug and go backwards at times as well. It's a pity because about 500 votes will have been done in the first poll, which would have been good anecdotal 'eye-catching' evidence.

your gut : a bag and 2 pipes

stomach : small bag on the upper left abdomen. preparation bag.
small intestine : long thin coiled pipe designed for maximum absorption
colon : wide shorter looping (one loop) pipe. recycling plant. loads of bacteria

The digestion system seems likely to play a part in fecal body odor and other metabolic body odors (e.g. secondary trimethylaminuria), so it's probably important we understand it best as possible. This post is about the basic visual and mechanical structure and main purposes. What does the gut look like and do ?

Stomach : a small bag on the upper left hand abdomen. This is where food first ends up. Generally it is held here and turned to mush and then released into the small intestine through the pyloric valve in small controlled amounts. Simple carbs won't stay long, whereas a meal will take a while. Hydrochloric acid is added to it, and some other things to make it easier to digest. The mush is called 'chyme'. Each part of the intestine is separated by valves.

Small intestine : A long thin pipe that coils in an overlapping way. This is the main absorption point. It is designed for maximum absorption of molecules of a certain small size. There are millions of finger-like microvilli on the lining (like a carpet) to make 'catching' the molecules easier. It's this microvilli that is wiped out in full-blown celiac. The pancreas puts digestive enzymes into the pipe early on to break down the food, and bile is also squirted in by the gallbladder to digest fats. The absorbed molecules go into the portal vein and then are taken to the liver for filtering before entering the main circulation. The intestine acts as a barrier so that large molecules cannot get into the portal vein unless broken down. With leaky gut (which is really leaky small intestine), large molecules can get through junctions in the barrier and so are absorbed when they shouldn't be. Because you want maximum absorption here, there is usually very few gut microbes here, especially at the top end, largely because they would compete with you for the food. The small intestine is known as 3 parts ; duodenum, jejunum, ileum. Many feel that when someone has gut candidiasis overgrowth, it's growing at the ileum (for example). However, it's likely that overgrowth of anything in the colon will cause problems too. The small intestine and colon are separated by the ileocecal valve.

Large Intestine/colon : A short, wide pipe that ascends from your appendix area, goes up to your ribcage and across, and down the other side and then loops to the anus. the colon is where most bacteria is, even in a healthy gut. Good flora scavenges from any leftover food/chyme and many produce helpful fatty acids. The protein/sulfur eating bacteria tend to be at the lower left side of the colon (near the end). The chyme becomes feces as water is absorbed and the 'rubbish' is then exited.

It's probably more complicated than that but hopefully this gives you an image in your mind of what the gut mechanically looks like.

What goes wrong ?

Some examples. If anything is wrong with the digestion enzymes such as HCL, pancreatic enzymes, bile etc, you can end up with too much undigested food entering the colon which will likely alter the flora ecology detrimentally. for instance too much protein getting into the colon.

If the tight junctions in your small intestine barrier cells are weakened you can absorb molecules too big that are not intended to be absorbed. These enter the portal vein and are sent to the liver which likely regards these as unexpected molecules.

If conditions aren't right, perhaps microbes can colonize the lower small intestine or further up.

Perhaps the colon microbes can be unnaturally altered and produce toxins. In Secondary TMAU, the diagnosis means there is too much trimethylamine produced. It's currently thought the bacteria that produce this are in the colon, so it means overgrowth of this bacteria. Who knows if this bacteria can grow in the small intestine as well. Presumably no-one is currently looking whereas a Body Odor & Research center likely would be.

10 minute halicheck at Breezecare Breath Clinic

The Breezecare Breath Clinic in London appears in google ads for halitosis searches. Breezecare's first clinic was in Australia, founded by Dr Geoffrey Speiser. They seem to be focusing on halitosis sufferers and basing their help on halicheck 'breath testing'. In principle this seems the most sensible approach, but 2 potential obstacles would seem to be :

1. Most sufferers don't seem to be able to 'smell on demand'. It seems transient (otherwise, you would presume any dentist would tell them)

2. In the health-system, treatment is not based on a money back guarantee.

The good thing about this clinic is that it is offering an option of a 10-minute breath check (by a consultant rather than the Dentist). This seems a great 'cheap' choice for professional diagnosis. It keeps costs as low as possible, and the halicheck is at least a 'real test' (i.e. you get a bit of paper). However, the confidence in the halicheck can't be judged currently, and also since many sufferers can't smell on demand, there's a good chance they won't be smelling on the day. The clinic itself does seem to be trying it's best in the halitosis arena. Like most/all, they are likely unaware of metabolic halitosis.

That said, anyone taking up this option is suggested to keep expectations low, except perhaps, if you have traditional 'classic' permanent localized halitosis. But it is posted in good faith so that the option is known about.

It would be interesting to know of any results. An email has been sent asking about the price.

---

Breezecare blog
News video featuring Dr Speiser of Breezecare
Yahoo7 haltitosis news video featuring Dr Speiser of Breezecare and related text link
Oral Chroma 'Halicheck' (what Dr Speiser uses)
Halimeter (Alternative breath-test machine)
wikipedia : Halimeter

Breezecare clinics : Sydney, Melbourne, London, Kota Kinabalu

Goodbye 2008, Hello 2009

We have had a very rich year full of hope and unity. We have grown very close to each other at many levels, as fellow-sufferers who strive to heal ourselves and each other physically, emotionally, and socially. We are people of all ages, races, nationalities, and walks of life, yet we are drawn together from all around the world! What is this magnetism that calls to us to get together, to get to see each other in person in meet-ups, and to talk to each other in conference calls and personal phone calls in addition to our forum posts?

There is something bigger and stronger than each one of us individually at play here that is leading us on the right path to find answers to our condition and to a cure. We are a very diverse community held together at our innermost level by a common experience. We have discovered in each other a part of ourselves. Individually, we have always felt we were unique and alone in the world, and now we discover that we not only share so much in common with each other, but that we also complement each other with our uniqueness, our individual talents and perspectives that we bring forth from our uniqueness and our background.

If we have reached these heights as a group in less than a year, God only knows what's in store for us in 2009, and what we can accomplish together; the sky is the limit! Let's reach for the stars!!!

María

---

GOALS FOR 2009:

*fundraising to organize group testing for research
*establishment of Metabolic Body Odor Charity
*new forum site for MSN
*more interviews with experts to post in our blog
*webinars with experts
*more meet-ups throughout the world
*support research efforts in Australia, UK, US, and other parts of the world...