Q: My husband has night sweats with a cheesy smell. It's been going on for almost two months. He says he feels fine. He doesn't seem worried, but I am. Should he see his doctor?
A: Since your husband otherwise feels well, it's likely nothing serious. But he should still make an appointment with his doctor.
The cheesy smell also is not unusual. Some Swiss researchers actually studied the smell of sweat in men and women. Sweaty men tended to smell like cheese, while sweaty women smelled like onions or grapefruit.
When a patient comes to me with new night sweats, I start by asking about the temperature of the bedroom and the number and type of blankets. Assuming that he is not getting overheated because of a warm room or bedding, I would make sure your husband is not having fevers during the day. I also would want to confirm that he has a good appetite and his weight is stable.
If he hasn't already been periodically checking his temperature with a thermometer, he should do that several times per day over a few days. If he is not experiencing fever or weight loss, then the reason for the night sweats is unlikely to be something like an infection, an inflammatory disorder, or cancer.
Other important but less serious possibilities I consider include:
--Sleep apnea, especially if he snores, is sleepy during the day, or both
--A side effect of a medication. He should review any medications, herbs, or supplements he takes with a pharmacist
--Low blood sugar (though this is not likely unless he has diabetes)
--An overactive thyroid (hyperthyroidism). Usually there would be additional symptoms, such as weight loss despite a good appetite, rapid heartbeat, sweating during the day, and feeling jittery
--Other hormonal disorders
While waiting to see his doctor, here are some things he can try to decrease the sweats:
--Keep the bedroom cool and open a window
--Avoid spicy food, especially at night
--Avoid alcohol for a while
Quite often, no specific cause for night sweats is discovered. In these cases, the sweats usually go away on their own.
(Howard LeWine, M.D., is an internist at Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)