Q. My breath and urine smells bad after following a ketogenic diet for celiac. Why?

Answered by
Dr. Sugreev Singh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 25, 2020

Hi doctor,

I am 23 years old male with a weight of 64 kilograms and a height of 5 feet. I am taking medications such as Propranolol 80 mg, Amphetamine XR 25 mg, Carisoprodol 350 mg, and Clonidine 0.2 mg. I am taking supplements with 1 gram of Quercetin or 200 milligrams of Bromelain twice daily and 410 milligrams of Jiaogulan twice daily. I have celiac and follow a strict ketogenic diet.

I take limited sugar of 40 grams per day due to migraine prophylaxis. I think that I may have dietary-induced ketosis because my feces smells sweet almost pretty and ketogenic. I have an acetyl smell in my breath and urine. I avoid taking supplements with acetyl groups. Is there anything that you would recommend to me? I have poor sodium reabsorption and adrenal function with low blood pressure. It gets raised after a few hours after taking a large dose of Folate 5 milligrams.



Welcome to icliniq.com.

Thank you for writing and I understand your concern. I would recommend continuing the same diet followed currently because everything seems to be under control. As you are facing some smell in your breath and urine, then I would recommend you to do biochemistry of blood which includes liver function test, kidney function test, serum electrolytes with urine routine microscopic examination. After getting the results, send me the reports. If anything is remarkable, I will let you know and suggest medicines accordingly. It can also be due to urinary tract infection or nephritis. Please let me know if there is anything.

The Probable causes:

Bacterial infection.

Differential diagnosis:


Probable diagnosis:

UTI (urinary tract infection).

Treatment plan:

After investigation.

Preventive measures:

Drink more filtered water.

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