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Sulfur Metabolism as Source of Bad Breath

In most cases, mouth bacteria are the source of bad breath. If the dentist can't find the problem, ask the doctor if it could be systemic.

What causes bad breath? It turns out that there are numerous situations that could be the source of bad breath. Which one might be relevant for you?

Reader Identifies Defective Sulfur Metabolism as Source of Bad Breath:

Q. I suffered from terrible body odor and horrible bad breath. Then I was diagnosed with an enzyme deficiency for sulfur; my body is unable to process sulfur compounds normally. In my case, these sulfurs were excreted as breath, body and foot odor. I now avoid garlic, onion, egg yolks and other sulfur-containing foods, and the problem has stopped.

A. Some people are susceptible to bad breath and body odor resulting from sulfur-containing foods. Even people who do not have an enzyme deficiency may experience bad breath or body odor due to bacteria in the gastrointestinal tract reacting to such foods (International Journal of Molecular Sciences, April, 2020). Meat, especially organ meats, seafood such as scallops, shrimp and mussels, legumes like soybeans, black beans and kidney beans and nuts such as almonds, Brazil nuts and peanuts are all rich in sulfur. 

Mouth Bacteria and Halitosis:

Metabolic disorders such as an inability to metabolize sulfur are probably much less common as a source of bad breath than bacteria in the mouth. Dentists frequently encounter halitosis as a symptom of periodontal disease in their patients (Periodontology 2000, June 2016). Treating the gum disease can help. In addition, people who scrape their tongues regularly for cleaning may also reduce their bad breath (Clinical Oral Investigations, April 2019). 

Could Helicobacter Be Making Your Breath Smell?

Some readers report that treating Helicobacter pylori made their bad breath disappear. Researchers believe that Helicobacter infecting the stomach lining could be a source of bad breath, but they point out that bacteria living in the mouth might be even more important (Helicobacter, Feb. 2019).

Does Your Medicine Cause Bad Breath?

Many medications (especially anticholinergic drugs) can cause dry mouth as a side effect. That in itself may be a source of bad breath. In addition, certain compounds such as dimethyl sulfoxide, disulfiram and cysteamine are metabolized to smelly sulfur-containing chemicals like dimethyl sulfide (European Review for Medical and Pharmacological Sciences, Nov. 2017).

People concerned about bad breath that doesn’t respond to treatment should discuss the problem with their health care provider. While serious health problems are rarely the reason that breath smells bad, a doctor may need to do some careful diagnostic work to rule them out.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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