My client's sweat smells like ammonia, yet he is fully hydrated. Do you know what this imbalance is and how to correct it?
To address your question, we must first ask a few questions. How old is your client? Does he take any medications that will interfere with metabolism, specifically glutaminase enzyme inhibitors? Does this person have any renal (kidneys) problems? Is he on a "starvation" type of diet or the popular "ketogenic" diet?
When people emit an odor that is "unusual," it is for a reason. Ammonia excretion is generally due to some or all of the above reasons. It may also be due to diabetes. Some people do not even know they are in the stages of diabetes and go on for a while in a catabolic state. This continues until they feel so lousy they go to their doctor. This catabolic (tissue breakdown) state is created by the incomplete oxidation of fats and skeletal muscle wasting (gluconeogenisis). This produces a great load on the renal system and in turn elevates the blood levels of urea. Urea is one by-product of ammonia metabolism.
Another thing that may be the cause is the use of high levels of corticosteroids. This type of steroid decreases the level of glutaminase enzymes, which in turn decreases the ability to metabolize glutamine. Excessive levels of glutamine increase the ammonia levels. In fact, 60 percent of ammonia secretion is derived from glutamine catabolism. The other 40 percent is from the other amino acids.
Our last "simple" possibility is your client is starving. He is on an extremely low calorie intake and is burning fat and muscle. Starvation creates an unusual amount of ketones, nitrogen metabolism becomes overwhelmed and produces an elevated urea excretion in the sweat.
These are probably things you already thought about, but sometimes confirming your suspicions can help trouble shoot problems. When in doubt, have your client go to his health care provider and, at minimum, get a blood and urine test. Good luck!
- Guyton, A. Textbook of Medical Physiology Saunders Publishing. Philidelphia. (1986)
- Hawley, R. et al. Hyperammonia possibly due to corticosteroids. Archives of Neurology vol.57.pp1085-1087 (2000)
- Dhabbi, J.et al. Calories and aging alter gene expression for gluconeogenic, glycolytic and nitrogen metabolizing enzymes. American Journal of Physiological Endocrinology and Metabolism vol.277. pp352-360 (1999)
- Houston, M. Biochemistry Primer for Exercise Science. Human Kinetics. Champaign,Ill. (1995)