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Sweating and body odor

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When to seek medical advice

See your doctor if you suddenly begin to sweat more than usual or experience night sweats for no apparent reason. A cold sweat is usually your body's response to a serious illness, anxiety or severe pain. Seek immediate medical attention for a cold sweat if you have signs of lightheadedness or chest and stomach pains.

Also talk to your doctor if you notice a change in body odor — it may be a sign of certain medical conditions. A fruity smell, for example, may be a sign of diabetes and an ammonia smell could indicate liver or kidney disease. In addition, a rare condition known as fish-odor syndrome (trimethylaminuria), causes an odor similar to rotting fish. People with fish-odor syndrome have a defective gene that prevents them from metabolizing trimethylamine (TMA), a natural byproduct of the digestion of foods such as saltwater fish, eggs and liver.


Your skin has two types of sweat glands: eccrine glands and apocrine glands. Eccrine glands occur over most of your body and open directly onto the surface of your skin. Apocrine glands develop in areas abundant in hair follicles, such as your scalp, underarms and genitals.

You have between 2 million and 5 million eccrine sweat glands. When your body temperature rises, your autonomic nervous system stimulates these glands to secrete fluid onto the surface of your skin, where it cools your body as it evaporates. This fluid (perspiration) is composed mainly of water and salt (sodium chloride) and contains trace amounts of electrolytes — substances that help regulate the balance of fluids in your body.

Apocrine glands, on the other hand, secrete a fatty sweat directly into the tubule of the gland. When you're under emotional stress, the wall of the tubule contracts and the sweat is pushed to the surface of your skin where bacteria begin breaking it down. Most often, it's the bacterial breakdown of apocrine sweat that causes a strong odor.

A number of factors can affect how much you sweat and even the way your sweat smells. Certain foods, drugs or medical conditions can cause excessive sweating, whereas drugs or conditions may interfere with your ability to perspire normally.

Excessive sweating (hyperhidrosis)
Some people sweat more than others for no apparent reason. But some factors may make you sweat heavily. These include:

  • Heredity. Some people inherit a tendency to sweat excessively, especially on their palms and the soles of their feet.

  • Certain foods and beverages. Drinking hot beverages and those that contain caffeine or alcohol can make you sweat. Eating spicy foods can do the same thing.

  • Certain drugs. Drugs that can cause excessive sweating include some antipsychotic medications used to treat mental disorders, morphine and excess doses of the thyroid hormone thyroxine. Overdoses of analgesics such as aspirin and acetaminophen (Tylenol, others) also can cause intense sweating.

  • Menopause. Women going through menopause may experience hot flashes — a rise in skin temperature accompanied by sweating and a feeling of intense heat — due to a drop in estrogen levels. Some menopausal women may also be awakened at night by soaking sweats followed by chills.

  • Low levels of male hormones. Men with low levels of the male hormone testosterone or a condition known as hypogonadism — which caused reduced functioning of the testicles — also can have hot flashes.

  • Low blood sugar (hypoglycemia). This occurs when the level of sugar in your blood drops below a certain level. It's most common in people with diabetes who take insulin or oral medications that enhance the action of insulin. Early signs and symptoms include sweating, shakiness, weakness, hunger, dizziness and nausea. Some people may develop low blood sugar after eating, especially if they've had stomach or intestinal surgery. In rare cases your body may produce too much of the pancreatic hormone insulin, leading to low blood sugar.

  • Fevers. A fever occurs when your temperature rises above its normal range. You may have a fever with many types of bacterial and viral infections, ranging from a mild case of the flu to serious illnesses such as pneumonia. When your body temperature finally begins to return to normal, you may sweat profusely, which is your body's way of dissipating the excess heat. Fevers followed by shaking chills may indicate a serious infection.

  • Overactive thyroid (hyperthyroidism). Sometimes the thyroid gland produces excess amounts of the hormone thyroxine. This can cause a number of signs and symptoms, including weight loss, a rapid or irregular heartbeat, nervousness and increased sensitivity to heat. It may also cause you to perspire much more than normal.

  • Heart attack. This occurs when a loss of blood supply damages or destroys part of your heart muscle. A heart attack may sometimes be fatal. The symptoms of a heart attack include pressure, fullness or squeezing pain in your chest that lasts for a few minutes or pain that extends beyond your chest to your shoulder, arm or back; shortness of breath and intense sweating. If you experience these symptoms, get immediate medical care. Every minute counts after a heart attack.

  • Tuberculosis. When left untreated, tuberculosis can be fatal. Among its signs and symptoms are a cough, slight fever and night sweats.

  • Malaria. A disease that occurs primarily in rural areas of tropical and subtropical countries. The symptoms are related to the life cycle of the parasite that causes malaria, and may begin anywhere from 8 days to 1 year after you've been infected. Initially, you may have chills, headache, vomiting and nausea, but as your body temperature falls, you begin to sweat profusely. The cycle may recur every 48 or 72 hours.

  • Certain types of cancer. Leukemia and lymphoma can produce unusual sweating patterns.

Decreased or nonexistent sweating (anhidrosis)
Most people worry about excessive sweating. But some people sweat very little or not at all — a condition that can be potentially life-threatening. Factors that may affect your ability to perspire normally include:

  • Certain drugs. Antipsychotic medications used to treat serious mental disorders may interfere with the functioning of the sweat glands.

  • Hypohidrotic ectodermal dysplasia (HED). Children with this rare disorder are born without sweat glands, which puts them at high risk of death from overheating (hyperthermia) — especially in hot environments. So far scientists have identified two genes that may be responsible for HED.

  • Autonomic neuropathy. This disorder damages the nerves that help control some of the involuntary functions of the autonomic nervous system, which regulates your internal organs, sweat glands and blood pressure. Damage to these nerves can interfere with the activity of your sweat glands, making it hard for your body to maintain its normal temperature.

  • Infections. Severe infections of the sweat glands — such as hidradenitis — may prevent the glands from functioning normally.

  • Burns. Major (third-degree) burns — either from fire, chemicals or electricity — can damage the skin as well as sweat glands, muscle and even bone.

  • Dehydration. This occurs when you don't have enough water in your body to carry on normal functions. You can easily become dehydrated when you work or exercise in hot weather and don't drink enough fluids to replace what you've lost through perspiration. Other common causes of dehydration include persistent vomiting or diarrhea or the use of medications that increase the flow of urine (diuretics). Eventually, you may lose so much water that you're no longer able to sweat. Signs and symptoms may include thirst, weakness and confusion. Severe dehydration can be fatal. Older adults and young children are especially at risk.

  • Heatstroke. Like dehydration, heatstroke can occur when you work or exercise strenuously in hot weather and don't drink enough to replace the fluids you've lost. Older adults, people who are obese and children with HED are at high risk of heatstroke. Heatstroke is particularly serious because your body's normal mechanisms for dealing with heat stress, such as sweating, are lost.

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