Acetate Smell

[SB_1108]

I have noticed that I can smell acetate/acetone on my skin, in my urine and stool. At first I thought it was ketones because it’s a sweet chemical smell but the ketone tests are negative. My Organix Acids test shows very elevated acetate as well as my stool analysis testing.

The doctor recommended probiotics and antibiotics for SIBO but I’ve tried every imaginable product/medication and still have major gut issues. I can only eat about 5-6 foods. Could it be something else? Fungal? Parasitic? Viral?

Any ideas on how to mop up acetate or how to make it convert into something less damaging?

 

[Learner1]

What 6 foods can you eat? What is the composition of your microbiome? What exact interventions have you tried? How much proprionate and butyrate did you have?

A little digging shows acetate is made from acetate forming bacteria in the gut, especially with high calorie density foods.

And, animal and human data suggest a direct regulatory role of acetate in several pathways involved in energy expenditure and fat utilization. Have you felt better or worse has this has occurred?

Apparently, when acetate levels rise, your body burns the acetate preferentially, since acetate is basically the same product of beta oxidation of fatty acids and glycolysis (glucose to pyruvate to acetate), but it doesn't require the metabolic work to produce.

So, it seems that changing the composition of your microbiome might help. If its that bad, a fecal transplant mainly be a consideration. And using l-glutamine to improve your gut lining, then using a set of insoluble fiber probiotics to targeted probiotic strains, rotating them over time to increase diversity, might help.

 

[Thinktank]

I have that problem too, no idea what's causing it.
It does not happen that often though.
The smell is primarily coming from my fingers and urine.

I remember the first time it happened was in high school, the night before i got very drunk and felt super dehydrated the following morning. The smell coming from my fingers was so pungent that i skipped school that day.

 

[Learner1]

Alcohol converts to acetate in your body, so that makes sense.

 

[SB_1108]

@Learner1 Thank you this is helpful. The six foods I can eat are 1) Chicken, 2) Zucchini, 3) Kale, 4) Green Beans. 5 and 6 are more questionable... I can eat a SMALL amount of pecans to prevent myself from going into ketosis and I can occasionally eat some other lean forms of protein like pork.

I'm not sure what you mean by "what is the exact composition of my microbiome?" - Every time I have a stool analysis I receive different results. Anaerobic bacteria appears to be a consistent problem. I've tried Xifaxan, Amoxicillin, Erthromycin, Flagyl, Clindamycin, Nystatin, Diflucan, and herbals like berberine, neem, allicin, FC Cidal, Dysbiocide, uva ursi, grape fruit seed extract, plant tannins, artesiminin, black walnut hull, clove and wormwood. Most of those just made things worse or didn't help at all. And any prebiotic just makes things 100 times worse. I can only tolerate bifido probiotics, no lacto strains. I've found that a supplement called Candibactin AR is helpful - it has thyme, oregano oil and lemonbalm. I've tried many fecal transplants and it doesn't help. Glutamine doesn't help either. Pepto bismol is helpful.

I have low butyrate, low SCFA, and my propionate doesn't even register. Its like I'm only creating acetate! I get these acetate smells right before a worsening of my symptoms.

Do you know what bacteria are the primary acetate forming?

I agree that changing the bacteria seems to be the way to fix it but i don't seem to tolerate anything that would modify that bacteria so I'm starting to think there must be some other cause.

@Thinktank - YES I can also smell it on my fingers! I can't tolerate alcohol at all.

 

[Learner1]

@Learner1 Thank you this is helpful. The six foods I can eat are 1) Chicken, 2) Zucchini, 3) Kale, 4) Green Beans. 5 and 6 are more questionable... I can eat a SMALL amount of pecans to prevent myself from going into ketosis and I can occasionally eat some other lean forms of protein like pork.

Those don't sound too calorie dense. What happens when you eat 5, 6, or anything else?

I'm not sure what you mean by "what is the exact composition of my microbiome?" - Every time I have a stool analysis I receive different results. Anaerobic bacteria appears to be a consistent problem.

So, the last time you did a stool test, did you get a list of what you do have? Is there a way you can post it or PM me with the list? It sounds like you might be missing some useful ones and you have too many that are going rogue on you.

I've tried Xifaxan, Amoxicillin, Erthromycin, Flagyl, Clindamycin, Nystatin, Diflucan, and herbals like berberine, neem, allicin, FC Cidal, Dysbiocide, uva ursi, grape fruit seed extract, plant tannins, artesiminin, black walnut hull, clove and wormwood. Most of those just made things worse or didn't help at all.

Wow! Those will all kill things. Sometimes that's good. But perhaps you killed a few too many that you need?

And any prebiotic just makes things 100 times worse. I can only tolerate bifido probiotics, no lacto strains. I've found that a supplement called Candibactin AR is helpful - it has thyme, oregano oil and lemonbalm.

Lemon balm, thyme oil and oregano oil are all natural anti-bacterial agents. They can act against bad bacteria and somewhat against parasites and have other good characteristics, like antioxidant properties. However, my guess would be you're still killing things that perhaps you need.

I've tried many fecal transplants and it doesn't help.

Our local hospital does these. Did you do it under the care of a gastroenterologist at a hospital? If so, what what was his/her story about why the fecal transplants failed? It seems like something must be killing off the bacteria.

Glutamine doesn't help either. Pepto bismol is helpful.

Glutamine helps to rebuild a damaged intestinal lining, which might or might not be helpful in your case. Pepto bismol's active ingredient, bismuth subsalicylate has anti-inflammatory and bactericidal action.

So, you may still be killing bacteria, whether you intend to or not.

I have low butyrate, low SCFA, and my propionate doesn't even register. Its like I'm only creating acetate! I get these acetate smells right before a worsening of my symptoms.

That sounds right. I'm not a doctor, but it certainly sounds like your microbiome composition is an issue. Figuring out how to repopulate your gut with happy bacteria that make butyrate, SCFA, and proprionate, without killing anything off. These might be worth reading:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939913/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923077/

Do you know what bacteria are the primary acetate forming?

Several kinds can form them.

https://www.ncbi.nlm.nih.gov/pubmed/15182395

I agree that changing the bacteria seems to be the way to fix it but i don't seem to tolerate anything that would modify that bacteria so I'm starting to think there must be some other cause.

It sounds like you have a serious problem which you do need to address - repopulating your gut. Is there a gastroenterologist or functional medicine doctor you could consult, which seems like a really good idea?

The Internet resources I know of that may be able to help you might be Andrea Nakayama, Jini Patel Thompson, or Ken Lassessen.

From dealing with 10 years of intestinal issues with multiple family members, I've learned that some interventions might rile things up even though they're positive steps to be taking.

But, failing a doctor supervised fecal transplant from a healthy person, the basic steps of what you'd need to do would be to feed the gut lining, then add some lacto and bifidobacteria, then some insoluble fiber (prebiotics) to feed whatever you put into your gut, then more probiotics, lacto and bifido, then start rotating probiotics (over 2-4 months), adding prebiotics appropriate to the strains of probiotics so that they are nurtured. This article might be helpful:

https://www.naturalmedicinejournal....t-intestinal-permeability-defects-and-related

In the meantime, you might want to think about how nutrition is getting into you as if you don't have bacteria to process nutrients and convert them to nutrient forms. There are IV nutrients and elemental diets that might be possibilities if you can't get this solved quickly.

Sorry I can't help more, but it sounds like you have your work cut out for you. (And I hope I'm wrong.. I'm not a doctor, just another patient...)

Hang in there!

 

[Cog71]

I've had this. Is it like a very strong, sweet, not altogether unpleasant but very unusual smelling urine? I've had it about five times and each time it lasted a couple of weeks or more. I tried telling various doctors but as i thought got brushed off each time.

The only interesting thing for me is that I never had this happen before I got sick, and that the episodes always come during a flare. Oddly, though, it always goes away by itself. Despite tracking food and drink intake, medication + supplements etc, I've never been able to put my finger on why it happens.

 

[Judee]

My mom has this with her urine and as I was trying to research what might be causing this, I found a post on another website by a woman who said her son has this smell to his breath whenever he uses Albuterol.

Lo and behold, my mom uses Albuterol too. I haven't charted this on paper but it does seem like she gets it closely after taking a dose--I mean within a 24 hour period.

(Sorry, I don't have a link to that post. I read so much on the internet that I'm not always able to find things I've read previously.)

Just thought I would mention this in case that might be a factor in your situation.