Smelly sweat in bed - only on some nights

[SilentP]

Hi

Started this thread a while back
https://www.diabetes.co.uk/forum/threads/blood-sugar-below-48-but-several-diabetes-symptoms.183965/

I will post a proper update on there at some point but have a specific question below.

The brief update is that the GP says that my blood sugar levels mean that I am not diabetic.

The tests revealed that I had a urinary tract infection, which was a surprise to me. I was given a short course of antibiotics and was clear after a third test.

My 'symptoms' have not got noticeably worse in the last few months. I have reduced carbs such as potato and bread (perhaps by a third to a half), have avoided most sugary food (except over Christmas where it did not seem to particularly affect me), kept alcohol intake reasonably low and am exercising regularly - probably above average fitness for a man of 67.

The reason for this post is to find out more about smelly sweat.

I am not an overly sweaty person, perhaps sweating a bit less than I used to. I do not suffer badly from normal body odour nor smelly feet.

What has been happening for several months (from prior to my original post) is that I am sometimes waking up in a sweat. I always wake up for a wee once in the night, usually 3-4:30am, in spite of drinking very little liquid in the evening and am sometimes sweating then.

Not every night, but sometimes the bed clothes can get quite smelly - so much so that my wife complains and you can smell it from a few feet away. It is probably that fruity smell I have read about and not like normal body odour. My urine can occasionally smell a bit fruity too.

I had assumed that this could be caused by high blood sugar levels, but a quick google suggests that it low blood sugar could be the cause.

Please can you give me some feedback on this and pointers where to research further.

Thank you

 

[LittleGreyCat]

Hi

Started this thread a while back
https://www.diabetes.co.uk/forum/threads/blood-sugar-below-48-but-several-diabetes-symptoms.183965/

I will post a proper update on there at some point but have a specific question below.

The brief update is that the GP says that my blood sugar levels mean that I am not diabetic.

The tests revealed that I had a urinary tract infection, which was a surprise to me. I was given a short course of antibiotics and was clear after a third test.

My 'symptoms' have not got noticeably worse in the last few months. I have reduced carbs such as potato and bread (perhaps by a third to a half), have avoided most sugary food (except over Christmas where it did not seem to particularly affect me), kept alcohol intake reasonably low and am exercising regularly - probably above average fitness for a man of 67.

The reason for this post is to find out more about smelly sweat.

I am not an overly sweaty person, perhaps sweating a bit less than I used to. I do not suffer badly from normal body odour nor smelly feet.

What has been happening for several months (from prior to my original post) is that I am sometimes waking up in a sweat. I always wake up for a wee once in the night, usually 3-4:30am, in spite of drinking very little liquid in the evening and am sometimes sweating then.

Not every night, but sometimes the bed clothes can get quite smelly - so much so that my wife complains and you can smell it from a few feet away. It is probably that fruity smell I have read about and not like normal body odour. My urine can occasionally smell a bit fruity too.

I had assumed that this could be caused by high blood sugar levels, but a quick google suggests that it low blood sugar could be the cause.

Please can you give me some feedback on this and pointers where to research further.

Thank you

A fruity smell could be Ketones?
Unless you are on a ketogenic diet there shouldn't be a reason to be in ketosis, as you are not diabetic.
An easy way to check is to get Ketostix
https://www.amazon.co.uk/Ascensia-Ketostix-Reagent-Strips-Ketone/dp/B008ETHFN4/
Or you can buy them from a chemist or other online site.

You just dip them in wee and see if they change colour.

 

[Deleted member 527103]

Have you a meter to check your blood sugars?
If you think they are related to your odour, you need to measure rather than speculate to know for certain.
Maybe you could register for the free Libre trail and see what happens to your levels when you are asleep.

 

[Oldvatr]

Ketones smell fruity like acid drops. Can be a result of either extreme of blood sugar levels. Do you have a glucose meter? If not then instead of the ketostix advised above, you can purchase urine test strips that can test 10 or more parameters. Ketones, sugar levels, blood, protein etc. I get mine from the rain forest.

Ketones resulting from ultra high blood glucose is a potentially dangerous indication of ketoacidosis which requires medical attention. Ketones from low levels of sugar are less of a problem, but woiuld be accompanied by a hypo event which again might require intervention. Without a reading, you are guessing which you have, and the interventions that may be necessary are diametrically opposite to each other, so you do need to identify the cause.

Your description of diet would suggest that the ketones are unlikely to be at the low end and nutritional ketosis is not happening unless you are taking medications that would lower sugar levels below what one would expect by diet and exercise alone. I am assuming you are T2D and not using insulin.

 

[SilentP]

Thank you for the replies. Plenty to think about and investigate there.

I am on no regular medication but do take a high dose Vitamin D3 capsule every morning at this time of year.
So no insulin and possibly borderline type 2 diabetes.

 

[Oldvatr]

A conundrum indeed. If the smell is truly due to ketones, then this is evidence that your body is burning lipid energy (i.e. fat, not glucose). The fact that your blood sugars seem to be non diabetic, then something is controlling that. The weeing after midnight is showing one possible exit route, but your weight is apparently quite static, and no sign of obesity either, so the glucose is not turning into glycogen stores either. Your UTI could be an indicator that you are excreting a lot of sugar.

If you were very insulin resistant (a common malady for T2D) then your blood sugars would show that.

Think you do need to consider getting some method of measuring those parameters when this occurs.

One thought. The HbA1c blood test is an average value so if you are riding a roller coaster with your sugar levels all over the place, then it could still register an average value in range. There is a rare blood condition that some have which makes the HbA1c unreliable
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3912281/
Did the doctor take a finger prick test in the surgery?

 

[SilentP]

Thank you, very helpful.

It was a few months back but cannot recall a finger prick test - probably just bloods

Edit
Just dug this out

Haemoglobin A1c level - IFCC standardised

Specimen Type: Blood
Specimen Reference#: 1
Collected: 08 Sep 2021
Received: 09 Sep 2021
Provider Sample ID: 21B-25103907

Pathology Investigations

Haemoglobin A1c level - IFCC standardised Contact Number:[NOT KNOWN]
Our HbA1c test method has changed. HbA1c levels will be approximately
4% lower than those reported before 02/08/2021 (this equates to ~
2mmol/mol at 48 mmol/mol) . Please take account when monitoring HbA1c
levels. For more information please see:
www.exeterlaboratory.com/test/glycated-haemoglobin-hba1c/
HbA1c within the range of 42-47mmol/mol meets the diagnostic criteria
for pre-diabetes (assuming the patient is not already known to have
diabetes mellitus). Consider referral for structured education in the
National Diabetes Prevention Program via DRSS if clinically
appropriate. Please note HbA1c may not be suitable to diagnose diabet
es in pregnancy, anaemia, haemoglobinopathies and rapid onset diabetes
such as type 1 diabetes.
Specimen Source: Blood, Venous
Haemoglobin A1c level - IFCC standardised 42 mmol/mol

 

[MrsA2]

Just nudged into prediabetes back then.
I suggest you call surgery and ask for a new rest to see where you are now

 

[SilentP]

These are my results for the last few years, would be surprised if there has been an increase in the last few months

HbA1c
08 Sep 21 42
03 Jun 21 42
10 Nov 20 45
19 Oct 18 43
25 Aug 17 43
26 Oct 16 41
4 Nov 15 44

 

[KennyA]

Hi

Started this thread a while back
https://www.diabetes.co.uk/forum/threads/blood-sugar-below-48-but-several-diabetes-symptoms.183965/

I will post a proper update on there at some point but have a specific question below.

The brief update is that the GP says that my blood sugar levels mean that I am not diabetic.

The tests revealed that I had a urinary tract infection, which was a surprise to me. I was given a short course of antibiotics and was clear after a third test.

My 'symptoms' have not got noticeably worse in the last few months. I have reduced carbs such as potato and bread (perhaps by a third to a half), have avoided most sugary food (except over Christmas where it did not seem to particularly affect me), kept alcohol intake reasonably low and am exercising regularly - probably above average fitness for a man of 67.

The reason for this post is to find out more about smelly sweat.

I am not an overly sweaty person, perhaps sweating a bit less than I used to. I do not suffer badly from normal body odour nor smelly feet.

What has been happening for several months (from prior to my original post) is that I am sometimes waking up in a sweat. I always wake up for a wee once in the night, usually 3-4:30am, in spite of drinking very little liquid in the evening and am sometimes sweating then.

Not every night, but sometimes the bed clothes can get quite smelly - so much so that my wife complains and you can smell it from a few feet away. It is probably that fruity smell I have read about and not like normal body odour. My urine can occasionally smell a bit fruity too.

I had assumed that this could be caused by high blood sugar levels, but a quick google suggests that it low blood sugar could be the cause.

Please can you give me some feedback on this and pointers where to research further.

Thank you

I had night sweats while pre-diabetic and also since diagnosis. I still have them even though my BG is back in normal range. Having used a CGM device (a Libre) it seems that my sweats correlate with a 4-6am dip in my BGs into hypo territory. The received wisdom/assumption is that unmedicated T2s do not have hypos. However there are enough people reporting just this, possibly as a result of the Libre being made available for a free trial, that the assumption might need to be checked.

 

[SilentP]

Have had a think following all the helpful advice above and have a proposed short-term plan of action.
A bit more info before I go into that:

The night sweats and the smell that sometimes accompanies them are quite variable. Maybe started in the middle of last year. Sometimes go away, but I have had the sweat and some smell the last few nights.

The low blood sugar possibility is interesting. Although I may not have many carbs in the early evening, but do often have a bowl of muesli or oats an hour or two before bedtime.

Have never used any blood sugar testing equipment at home.

I used to be a bit heavier and had a less healthy lifestyle about 15 years ago.
I tried the Atkins diet for a few days back then and did not get on well with it. Pretty sure I went into ketosis and also got heart palpitations. I used to get those quite frequently at that time and had a radiofrequency ablation in 2008. I have only had them very rarely since then, usually if I have overindulged on alcohol and am tired.
So, overall I am in better physical shape with a better lifestyle than before - but I am no 67,

The Libre trial sounds appealing (was not sure which of the options to trial) but think I will keep that up my sleeve for a while.

The urine strips sound like a simple first step. Should be fairly easy to try them out at sweaty time as I usually wake up for a wee between 3 and 4. Will these do the job?

shorturl.at/loqAS

 

[Oldvatr]

Have had a think following all the helpful advice above and have a proposed short-term plan of action.
A bit more info before I go into that:

The night sweats and the smell that sometimes accompanies them are quite variable. Maybe started in the middle of last year. Sometimes go away, but I have had the sweat and some smell the last few nights.

The low blood sugar possibility is interesting. Although I may not have many carbs in the early evening, but do often have a bowl of muesli or oats an hour or two before bedtime.

Have never used any blood sugar testing equipment at home.

I used to be a bit heavier and had a less healthy lifestyle about 15 years ago.
I tried the Atkins diet for a few days back then and did not get on well with it. Pretty sure I went into ketosis and also got heart palpitations. I used to get those quite frequently at that time and had a radiofrequency ablation in 2008. I have only had them very rarely since then, usually if I have overindulged on alcohol and am tired.
So, overall I am in better physical shape with a better lifestyle than before - but I am no 67,

The Libre trial sounds appealing (was not sure which of the options to trial) but think I will keep that up my sleeve for a while.

The urine strips sound like a simple first step. Should be fairly easy to try them out at sweaty time as I usually wake up for a wee between 3 and 4. Will these do the job?

shorturl.at/loqAS

Wee stix kept my T1D mum alive for 50 years, so there must be something in that. Not as accurate as the bgl meters, but ok as a rough guide. As I suggested before, get the 10 in one test strips like the doctors use to do test for ketones and proteins at the same time.

 

[SilentP]

Thank you - Order put in

 

[SilentP]

Have had the strips for a day and used 5 of them, all with similar results.

Woke up at about 2am drenched in sweat that did not smell - I can taste it above my upper lip when it does smell - but I usually sleep through for another hour or so before needing a wee. The sweating could be exacerbated by the bedclothes as I sweated less after moving to another bed.

Results so far look mostly pretty normal:

- Blood sugar down at the bottom end. However it does not tell you if your blood sugar is too low, so may need to try the Libre or another test to gauge that

- Blood is at the far right end (not sure if the same scale and colours apply to all of the strip tests). It is pale yellow with a lot of green in it i.e. Non Hemolysis ++80(?). From a bit of googling this may or may not not indicate a problem, that may or may not be another UTI (Nitrite was negative and Ketones were initially but seems to have changed wince the strips dried out - need to check that carefully next time)

- Density towards the far right, but I believe that is good

 

[Mrs HJG]

Hi @SilentP
I am not really knowledgeable enough to give any real thoughts on whether this is all diabetes related, but have you had a recent 'wellman' check up including PSA (prostate) and liver/kidney functions tests? My dad has had a few UTIs that don't clear with just one course of antibiotics, and he has had prostate cancer, kidney and gall stones. I suggest you need the full works not just diabetes-related checks; if your surgery and you are regisrered via the NHS app, you'll see your results in 24hrs to put your mind at rest. Good luck

 

[SilentP]

Thank you. They did a range of tests a few months back and I was OK on the items you list.
Unless I pick up some specific concerning result in the meanwhile, I think the plan will be to carry on with less frequent strip tests for a short while - and then look into a test for low blood sugar and then contact the doctor again after those results. Would really like to get to the bottom of the smelly night sweats and hopefully being able to sleep for longer before needing a wee

 

[EllieM]

Thank you. They did a range of tests a few months back and I was OK on the items you list.
Unless I pick up some specific concerning result in the meanwhile, I think the plan will be to carry on with less frequent strip tests for a short while - and then look into a test for low blood sugar and then contact the doctor again after those results. Would really like to get to the bottom of the smelly night sweats and hopefully being able to sleep for longer before needing a wee

Be aware that the urine test strips only detect sugar if your blood sugar goes above 10mmol/L (non diabetics are normally between 4-8 though they can spike higher), so the strips really don't tell you anything about blood sugar if you aren't diabetic. Ketones can be present in urine just from a low carb diet, though high ketones plus high blood sugars are a massive red flag for diabetes.

To test for low blood sugar, you'll really need a testing meter. Have you ever done a 24 hour urine collection? (It may be they only bother to do that for diabetics.)

 

[SilentP]

Thanks

Yes, I think a testing meter is probably required.

Am getting confused with mmol/mol and mmol/L
My last blood test was 42 mmol/mol
That appears to equate to 7 mmol/L
The guide for the strips has turquoise which it says i s neg (my results to date) and then a green with a hint of blue which it says is
+or-100 5.5 mg/dl(mmol/L)
5.5 mmol/l works back to 34 mmol/mol
Cannot make sense of that

Had never heard of a 24 hour urine collection - have just looked it up.

 

[EllieM]

Can you tell me the brand and name of the strips?

mmol/L and mg/dL are UK/US measuring units for sugar in blood

mmol/mol is a measurement of hba1c (essentially how much sugar binds to your blood cells over last 3 months, 42 for you). This used to be measured as a % (you'd be about 6%).

There shouldn't be any sugar in your urine if your blood levels have been staying under 10mmol/L

 

[Oldvatr]

Thanks

Yes, I think a testing meter is probably required.

Am getting confused with mmol/mol and mmol/L
My last blood test was 42 mmol/mol
That appears to equate to 7 mmol/L
The guide for the strips has turquoise which it says i s neg (my results to date) and then a green with a hint of blue which it says is
+or-100 5.5 mg/dl(mmol/L)
5.5 mmol/l works back to 34 mmol/mol
Cannot make sense of that

Had never heard of a 24 hour urine collection - have just looked it up.

The conversion of mmol/l to mg.dl you multiply the 5.5 by 18 which gives 99.
In the UK we use mmol/l, the other system is used in USA and others.

If buying a meter that might be useful in the future then go for one where the test strips are cheap since this dictates the cost of ownership.