Before-and-after photos taking social media by storm show people’s weight loss transformation with the keto diet. But one common side effect you may not have heard about is the bad breath that comes with this diet, called keto breath or ketosis breath. While the keto diet can help you lose weight, reduce your sugar intake and improve your overall health, it has drawbacks as well, including the development of bad breath.
What is Keto Breath?
Keto breath is a distinct taste or odor in the mouth that’s different from ordinary halitosis or bad breath. It is a side effect of following a ketogenic diet and being in ketosis. Ketosis is a natural metabolic state that occurs when you don’t receive enough carbs for energy and your body starts burning fat for fuel. The average diet is high in carbohydrates, which is what your body is used to digesting. When you opt for a lower carb intake, your body has to use up fat stores for energy, since you aren’t introducing any fast-metabolizing carbs. Ketosis is when your body is efficiently breaking down fat for energy. This broken-down fat, now fatty acids, are converted into ketones. The ketones are naturally occurring and aren’t harmful. They’re expelled from the body through breath and urination.
Many people describe the flavor of keto breath as metallic. Some describe keto breath as having a metallic taste in their mouth and a smell that’s sweet, fruity or similar to nail polish remover. Keto breath typically has a fruity odor or an aroma reminiscent to nail polish remover. Ketosis breath is an overly sweet, fruity scent (not in a good way) that is the results of the way our bodies break down fats. If you’re in ketosis, you may notice your breath tastes metallic or has a chemical smell.
Causes of Keto Breath
To understand the cause of keto breath, it’s important to understand how metabolism works. Your body gets energy from a variety of food sources, including carbohydrates, fat, and protein. Typically, your body will break down carbohydrates or glucose for energy first, and then fat. According to a study in the International Journal of Oral Science, lack of saliva may be a cause of bad breath in the morning.
Since the ketogenic diet and other low-carb diets purposely restrict your intake of carbohydrates, your body is forced to use its fat stores for energy once you’ve depleted your glucose stores. Ketosis occurs when your body breaks down fat for energy. Fatty acids are then converted into ketones, which are natural chemicals your body produces when you burn fat for energy. These include beta hydroxybutyrate, acetoacetate, and acetone.
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While in ketosis, your body converts fat cells into three types of ketones. One of these ketones, called acetone, is essentially worthless for your body to create energy. Therefore, your body releases it through your urine, sweat, and breath. Since acetone is an ingredient in some nail polishes, your breath smelling like nail polish remover in particular can indicate a state of ketosis. On the one hand, this indication that you’ve entered ketosis may be reassuring. On the other hand, it’s an unfortunate indicator.
Decreased carbs and increased protein intake can cause ammonia in the body. Ammonia is produced in the body as a result of protein breakdown. Ammonia is expelled when you breathe and urinate and causes foul breath.
Duration of Keto Breath
The duration of keto breath is temporary. You may notice a change in your breath within days or a week of starting a low-carb diet. Keto breath usually appears in the first week or two of doing the keto diet, and it isn’t permanent. However, the odor will subside as your body adjusts to a lower carb intake. Studies show a low-carb diet can help reduce cavities, gum disease and inflammation. This might take a couple of weeks, and there are a few things you can do to freshen your breath during this period of time. Eventually your body will become accustomed to its new carb intake levels and will get back to normal. However, it will return if you go on and off the diet.
How to Get Rid of Keto Breath
So, now that you are aware of keto breath, how do you get rid of it? Here are a few simple tips to reduce bad breath while your body adjusts to a low-carb diet.
- Increase your water intake: Staying hydrated with water should be at the top of any list of how to get rid of keto breath. Drinking more water may also help with your weight loss goals. Along with exhalation, your body flushes acetone and ketones from your system through urination. By drinking water, people will produce more urine, which will help expel many of the ketones from the body. Drinking water may also help flush out bacteria in a person’s mouth that could be causing bad breath. Fill a water bottle and sip throughout the day. Adding fresh herbs to water and tea. Stay hydrated and sip on water throughout the day to increase urination. This helps flush ketones from your body and improves your breath.
- Eat less protein: While protein is important on a low-carb diet, eating too much protein can worsen bad breath. The keto diet encourages low carb intake and eating large amounts of saturated fat in the form of butter, lard, and oils. As your body breaks down protein, it produces ammonia. This is another byproduct of metabolism that’s eliminated through urination and exhalation. Ammonia can create a strong odor on the breath, too. Decreasing your protein and increasing your consumption of healthy fats (avocados, nuts, olive oil) may improve your breath without forcing you to go off the diet. Instead of focusing on protein sources for your fat intake, try vegetable fats from avocados, olive oil, and almonds. Eating extra fat can help reduce ketone stinkers, such as ammonia and acetone.
- Practice good oral hygiene: Because the scent you're giving off is coming from your lungs, practicing good oral hygiene (which is always a good idea regardless of diet) will simply be covering up the smell, not fixing it. Brushing your teeth twice a day and daily flossing may not completely eliminate keto breath, but these practices can reduce the odor coming from your mouth. Bacteria can accumulate in your mouth and in between your teeth when you don’t brush or floss regularly. Since bacteria also triggers bad breath, poor dental hygiene can worsen keto breath. Always rinse your mouth with water after every meal and brush your teeth two times a day. Floss your teeth at least one time a day. Clean between your teeth with interdental brushes or water flossers at least once a day. Not only does the minty odor of toothpaste help mask the smell of keto breath, but brushing the teeth will help dislodge pieces of food in the mouth and teeth that can smell as they break down in a person’s mouth. Decay, plaque buildup, food particles, and tooth and gum diseases can cause foul breath. Employ oil pulling with coconut oil in addition to brushing, flossing, and scraping your tongue with a scraper. Oil pulling involves swirling oil in your mouth, which helps remove bacteria, leading to good oral hygiene and bright teeth. Oil pulling is usually done for five minutes two or three times each day. Keep brushing at least twice a day, floss once a day, and introduce a good mouthwash if you need some extra help.
- Mask odor with mints and gum: You may want to suck on mints and chew gum until your body adjusts to a low-carb diet. Sucking mints or chewing mint gum may be enough to hide the smell of keto breath. Chewing gum also increases the amount of saliva a person produces, which can help stop the bacteria that cause bad breath from growing in a person’s mouth. Chewing sugar-free gum will activate saliva production, which will keep your mouth free of bacteria. Make sure you choose sugar-free mints and gum. Be aware that some chewing gums and mints contain a small amount of carbohydrates. If you chew or suck on several pieces throughout the day, this could increase your daily intake of carbs and kick you out of ketosis. This helps restore the mouth's pH equilibrium, lowering the risk of tooth decay. If you want to boost the advantages, use sugarless keto breath mints or chewing gums containing xylitol. Sugarless gum and mints will not eradicate keto breath, but they will help hide it.
- Bump up your carb intake: Eating more carbohydrates should mean a person produces fewer ketones. As a result, they should breathe fewer ketones out and have less keto breath. Slightly increasing your carbohydrate intake can also eliminate keto breath. If you want to remain in a state of ketosis, only increase your daily amount of carbohydrates by a small amount. Adjust your intake of complex carbohydrates, such as leafy green vegetables and whole grains, while continuing to avoid refined carbs. Adding more complex carbohydrates, like leafy greens, will also help decrease the scent. The number of carbohydrates a person can eat without dropping out of ketosis will be different for each person but could be 20 (grams) g to 50 g if a person is consuming 2,000 calories a day. Let’s say you’re eating 15 grams (g) of carbohydrates per day. Try increasing your intake to 20 g per day to see if your bad breath improves. Then, use a ketone breath analyzer to measure your ketone level. Monitoring your ketone level is key to knowing whether you’re still in ketosis after increasing your carbs.
- Be patient: Sometimes, you can’t get rid of keto breath. So, if you’re committed to a low-carb diet to lose weight, be patient and allow your body to adjust to its new fuel source. Your bad breath will improve after a couple of weeks. Your breath should improve in a few weeks as your body adjusts to the lack of carbs.
Prevention of Keto Breath
There is not a clear way of preventing keto breath. Anecdotally, it is a side effect that almost everyone who puts their body into ketosis will experience. Keto breath is a side effect of ketosis and a low-carb diet, and there doesn’t appear to be a way to prevent the odor. According to a review of studies on the keto diet in the journal StatPearls, before the introduction of antiepileptic agents into the medical field, the keto diet was used to help children who had epilepsy. Now, it's used to lose weight fast and has shown to be effective. What you can do, however, is use a ketone breath analyzer to determine the most carbs you can eat without being kicked out of ketosis. If you can add more carbs to your diet and eat less protein, this might be enough to keep your breath fresh.
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If you notice keto breath and you’re not intentionally on the ketogenic diet or a low-carb diet, eating more carbs can quickly kick you out of ketosis and eliminate bad breath. For example, if you’re currently consuming 50 g of carbohydrates per day, up your intake to 100 g per day. You can increase your amount of physical activity to compensate for the added carbohydrates.
Other Signs of Ketosis
Keto breath is a clear sign a person is in ketosis. Another key sign is keto flu. Share on PinterestA person who has keto flu may experience nausea, dizziness, and headaches. According to some reports, keto flu normally goes away after a few weeks, once a person’s body adapts to ketosis.
- Nausea
- Vomiting
- Headaches
- Tiredness
- Dizziness
- Difficulty sleeping
- Constipation
Another possible sign of ketosis is a change in a person’s urine. Because of the increase in ketones a person’s produces, their urine is likely to be darker and have a stronger smell. Some people report that they have less appetite when in ketosis - although scientists are not sure why this might happen.
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