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The letter can explain that the odor is a known medical side effect of a life-saving medication, entirely unrelated to personal hygiene

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The adult body contains approximately 20 to 25 g of L-carnitine in total, distributed as follows: 98% in skeletal muscles (the legs in particular) which is why it plays such a central role in athletic performance 1.5% in the liver and kidneys where it is synthesized 0.5% in the blood and other tissues This distribution explains the close link between L-carnitine and muscle activity : it is in the muscles that it is most useful, and that is where needs can increase with physical effort