A Breathalyzer for Disease?

By Dr. Mercola

Humans have been given five interesting “super powers” — hearing, sight, taste, touch and smell, without which life may arguably be less rich and perhaps even dangerous. Today, however, recently developed breath-analysis technology can use “smell” to analyze and accurately diagnose 17 different diseases with 86 percent accuracy.

For example, the Na-Nose technology can identify multiple sclerosis, Parkinson's disease, several types of cancer, kidney failure and Crohn’s disease through the use of nanorays. According to CNN:

“The theory behind the technology is that each of us has a unique chemical ‘fingerprint.’ Each disease also has a particular chemical signature, which can be detected on our breath. The Na-Nose technology, which consists of a sensor chamber with a breathing tube and software, is able to detect this precise chemistry of disease by interpreting the impact on our usual chemical fingerprint.”¹

Researchers used nanorays (aka nanoarrays) for breath analyzation, which the journal ACS Nano noted was “validated by an independent analytical technique, i.e., gas chromatography linked with mass spectrometry [GC-MS].”²

Around 1,400 participants from different countries were tested using the Na-Nose technology, which accurately diagnosed disease approximately nine out of 10 times, Medical Daily reports, adding that if other diseases (besides the 17 specifically mentioned in the study) happen to be present in an individual’s “breathprint,” the device may detect those, as well.³ Those 17 detectable diseases include:

The study stated, “One breath sample obtained from each subject was analyzed with the artificially intelligent nanoarray for disease diagnosis and classification, and a second was analyzed with GC-MS for exploring its chemical composition.”⁴

Na-Nose Technology: ‘Inexpensive, Noninvasive and Easy to Use’

It turns out that the study, conducted by colleagues from Technion-Israel Institute of Technology and led by Hossam Haick, from the department of experimental technology development, revealed 13 exhaled chemical species known as volatile organic compounds (VOCs) are each associated with certain diseases, the composition of which differs from one disease to another, according to ACS Nano.⁵

Quartz cited research conducted over the last decade showing that with cystic fibrosis, for instance, patients’ bodies produce nearly quadruple the acetic acid — the base chemical in vinegar — compared to healthy people.⁶ Haick noted that besides boasting an equivalent accuracy to what’s currently available in the way of tools and expertise, Na-Nose breath analysis is not invasive, which can’t even be said about standard blood tests.

Further, the developers described the technology as easy to use, affordable and a “miniaturized tool” that could be used for personalized screening, diagnosis and follow-up. Na-Nose technology imitates a human’s or dog’s sense of smell to evaluate a patient’s breath, Medical Daily⁷ explains, and can assess whether someone is healthy and predict who among healthy people have the highest risk for disease in the future.

Haick stresses that one of the most important benefits of the device is to intercept diseases earlier, which may increase the chances of survival, especially for illnesses like cancer. In fact, Haick says the Na-Nose’s ability to detect lung cancer can increase survival rates from 10 percent to 70 percent.⁸

The scientists also noted that while detecting disease from breath samples has been used for infections, respiratory ailments and oncology (the study and treatment of cancer), the next step of sophistication in the process would be to not just diagnose an illness but classify its condition to determine the cause and appropriate therapy. Seven different companies have obtained licensing from Technion to develop commercially viable products for unique applications.

Haick said he hopes they’re able to take what was developed in a lab and bring it to mass production. One idea is to create a smartphone that could essentially be called a “sniffphone” for monitoring health. However, he doesn’t expect any such technology to be available — either to the medical establishment or to the public — for several years due to the necessary testing and regulation involved.

Ancient to Modern Technology and Potential Obstacles

Ancient Greek medical practitioners used the five senses to identify their patients’ physical maladies. Until more sophisticated methods came along, all they had at their disposal were these senses and medieval instrumentation such as probes and speculums, Brought to Life⁹ says. Ancient doctors used observations such as skin color, touching patients to analyze body temperature and pulse, listening to heart rates and stomach rumblings, and smelling their patients’ breath, body odor and even their urine and feces to diagnose illnesses.

Haick said the study expounded on the theme, noting that doctors circa 400 B.C. learned to evaluate their patients' possible link to disease by the VOCs their patients exhaled (although they didn’t call them VOCs then). “For example, the stools and urine of infant noblemen were smelt daily by their physicians.”¹⁰

Mangilal Agarwal, director of the Integrated Nanosystems Development Institute and an associate professor at Richard L. Roudebush VA Medical Center in Indianapolis, while not involved in Haick's study, is working on similar scent analysis technologies for disease diagnoses, specifically hypoglycemia, breast cancer and prostate cancer.

While Agarwal commends Haick's work and the Na-Nose technology’s noninvasive capabilities (especially in light of the “sufficiently unpleasant experience” involving a prostate biopsy) he and other scientists raise concerns regarding whether environmental fluctuations and different regions could conceivably produce air signals and other factors that might throw off the sensor’s readings.¹¹

Then there’s the call for smell technology requirements to first establish a profile of breath molecules for normal health, taking such variables as body mass index (BMI), gender, age and ethnicity into account. What subjects ate for dinner or mouth rinse usage might throw off breath analysis results, as would the failure to immediately test breath collections, as storing it for any length of time would doubtless skew results.

Dogs and Fruit Flies as Disease Detectors

Agarwal noted the canine connection to disease detection, which has fascinated the medical world for many years, CNN observed: “Breath has the scents or volatile biomarkers necessary to identify many diseases. We know this from canines who can detect hypoglycemia and epileptic seizures, fruit flies (and canines) that can detect cancer, and from giant rats that detect tuberculosis in Africa.”¹²

ChemoSense reported the work of Alja Lüdke and Giovanni Galizia, from the department of biology (and) neurobiology at University of Konstanz in Germany. The two noted in their paper "Sniffing Cancer: Will the Fruit Fly Beat the Dog?" that animals found to be highly sensitive to the smell of cancer may have sparked the first experimentation in electronic noses for cancer detection.

“Cancer cells have a fundamentally different metabolism compared to normal cells, not least due to their tendency to grow fast and in an uncontrolled manner … Cancer cells may produce cancer-specific metabolites, and/or shift the relative concentration of common metabolites. These changes are then reflected in the emitted odour profile of cancer cells.”¹³

Cancer doesn’t even have to be visible, Lüdke and Galizia wrote, relating the case of a dog who detected a cancerous lesion on a woman’s leg through her trousers, which turned out to be malignant melanoma. However, fruit flies, when tested, were found to have olfactory receptors (50 different types) that are nearly as sensitive, compared to a dog’s 1,000 receptor types, and also with surprisingly accurate instances of disease detection.¹⁴

Smell Receptors: Humans Versus Animals Versus Breath Technology

Canines have been shown to have 300 million smell receptor cells, and the part of their brain that analyzes different odors is 40 times larger than that of humans, most of whom possess around 6 million. The ability of trained dogs to detect disease in humans has been used all over the world. One study used hypoglycemic events in type 1 diabetes patients as a means to develop an alternative to diabetes alert dogs:

“Canines trained as diabetes alert dogs (DADs) have demonstrated the ability to detect hypoglycemia from breath, which led us to hypothesize that hypoglycemia, a metabolic dysregulation leading to low blood glucose levels, could be identified through analyzing volatile organic compounds (VOCs) contained within breath.”¹⁵

Studies that demonstrate how quickly and accurately dogs can detect serious diseases like cancer are numerous. One in Britain found them to pinpoint bladder and prostate cancers 90 percent of the time, and sometimes even more frequently.¹⁶ In another, a trained Labrador retriever was able to detect colorectal cancer from breath and stool samples with similar accuracy.¹⁷

Dogs have even been able to identify people with abnormal blood sugar levels and predict seizures before they happen, even before the individuals realize anything’s wrong. But dogs have also been known to have “flawed technology,” so to speak, as they don’t perform the same way every time. Technologies like the Na-Nose could exist independently from needing a dog or some other animal’s ability to “sniff out” sickness.

Coconut Oil and Peanut Butter: Detection and Potential Improvement

Your ability to smell may be a marker for your odds of developing Alzheimer’s disease or a related disorder. According to the Alzheimer’s Association, it’s a progressive brain disorder that destroys brain cells and is ultimately fatal.¹⁸ A 2014 study reported that in 2010, while death certificates cited only 84,000 people as dying from Alzheimer’s, in reality, more like 503,400 people in the U.S. aged 75 years and older died from it,¹⁹ and Alzheimer’s death rates have risen even further since then.²⁰

Scientists emphasize that early diagnosis and prevention strategies are crucial in slowing down this most common type of dementia. One of the most exciting breakthroughs, though, is also related to smell, in this instance being linked to diagnosing cognitive impairment early, which is crucial. Jennifer Stamps, who in 2013 was a graduate student at the University of Florida, devised the plan to test patients’ ability to smell peanut butter, a “pure odorant,” only detectable by the olfactory nerve.

Patients blocked one nostril at a time for the test, while clinicians held the peanut butter and a ruler closer to each nostril at 1-centimeter (0.39-inch) increments until the patients said they could detect the fragrance — or not.²¹ Per Medical News Today:

“The scientists found that patients in the early stages of Alzheimer's disease had a dramatic difference in detecting odor between the left and right nostril — the left nostril … did not detect the smell until it was an average of 10 cm closer to the nose than the right nostril had made the detection in patients with Alzheimer's disease.”²²

One day, the peanut butter method of dementia detection may become a standard for early Alzheimer’s intervention. As Stamps explains, “If we can catch it at that early stage, we can start treatment more aggressively, and you can possibly prevent a lot of the progression.”²³ Clinical studies show that coconut oil may be another substance with profound potential against Alzheimer’s disease.

It started with the theory that ketone bodies, an alternative fuel for your brain that your body makes when digesting coconut oil, might have brain benefits. As the study ensued, Dr. Mary Newport, whose husband, Steve, began experiencing cognitive decline at age 51, found that giving him 4 teaspoons of coconut oil per day resulted in dramatic improvements.

If you find you’re unable to smell peanut butter, it’s possible that you may benefit from using coconut oil. Until a treatment is found that will turn the symptoms of cognitive decline around or cure it outright, I recommend dosing yourself with coconut oil as described above (as well as making specific dietary changes); there are dozens of other benefits to gain as well.

As for the “breathalyzer” that may one day become the go-to tool for detecting early-stage diseases, perhaps Alzheimer’s will be among those conditions that it will ultimately detect.