When Topeka resident Cheryl Fields was a sophomore in college, she noticed a change in the way she smelled. Although she was already taking two showers a day, she squeezed in another shower when she went home for lunch.
The odor — which smelled like garbage or rotting fish — continued to worsen. Fields started carrying soap, washcloths and extra clothing wherever she went.
"I was constantly washing," she said. "At the worst point, I was taking 10 to 15 showers a day to try to wash off that smell."
When Fields ate at restaurants, diners at nearby tables would ask wait staff about an off-putting smell. When she heard someone whispering or snickering, she assumed they had noticed the odor.
"It was very stressful and frustrating," she said.
Fields said she went to doctors to find out why her body was producing the odor. She was greeted by skepticism and sighs. One doctor suggested she try more showering and douching. Another, she said, wanted to refer her to a mental health counselor or psychiatrist because "it was all in my head."
"I was in my 20s at that time, and I was a ball of confusion," she said.
Finally, in 1998, Fields got an answer. A urine test indicated she had trimethylaminuria, also known as TMAU, a rare genetic metabolic disorder in which the body is unable to break down trimethylamine, a compound derived from the diet and has a strong odor of rotting fish.
Trimethylamine builds up in the body of those with TMAU and eventually is released through sweat, urine, breath and reproductive fluids, according to the National Human Genome Research Institute/National Institutes of Health.
In some cases, Fields said, the odor is so strong it can permeate the walls of apartments and hotel rooms.
There is no known cure for the disease, which is present in about 1 percent of Americans. Onset of the disease seemingly can occur at any age.
Fields said she has a "transient" type of TMAU, which means she can be odor-free for as much as two weeks before it recurs.
Avoiding foods containing trimethylamine and choline, such as eggs, liver, peas, peanuts, soy products and broccoli, and using soaps and lotions with a low pH balance can reduce the odor, according to the National Human Genome Research Institute.
Low doses of antibiotics and riboflavin supplements also may help some people.
Despite having TMAU, Fields said she has carved out a successful career.
"It's from never giving up and striving for the big jobs," she said. "I have TMAU — it does not have me."
Fields, who has a bachelor's degree in business from Emporia State University and a master's degree in business administration from the University of Phoenix, has been employed as a manager and special investigator at the Kansas Human Rights Commission, adjunct professor at Johnson County Community College and human resources manager for Sam's Club/Walmart.
She also has been a self-employed human resources consultant and owner and general manager of the Kansas City Krunch, a women's semi-professional football team.
She currently is associate researcher and community outreach director for Mebo Research Inc., a not-for-profit company focusing on the diagnosis, treatment and cure for systemic and metabolic body odor and halitosis conditions.
Still, Fields said, those with TMAU can face harassment in the workplace. Others with the disorder have told her about co-workers leaving soap or laxatives on their desks or managers and supervisors joking about their odor. Some have lost jobs or not been hired because of the disease.
"Some employees feel outnumbered," she said, explaining it is often difficult for those with TMAU to seek support from human resources representatives.
Last month, Fields said she was asked to submit an essay describing a day in the life of a person with TMAU to the Social Security Administration, which is considering whether TMAU falls under its Compassionate Allowances standards and benefits should be made available to those individuals and their families.
If asked whether they would rather receive government assistance or have a job, Fields said work would win.
"Most people with TMAU want to have a life, work 8 to 5, go out with their co-workers and work up the corporate ladder," she said.