How to Stop Ketosis Breath

The Cause of Ketosis Breath

Although ketosis offers many neuroprotective, cognitive and fat-burning benefits, the production of elevated levels of ketones, along with excessive protein intake, can also cause a keto-specific form of halitosis (a.k.a., bad breath).

The bad breath often experienced while in ketosis, is primarily a biological response that occurs when increased ketones are produced by the body, and it’s not necessarily caused due to poor hygiene.

Keto breath is merely the result of an increased amount of ketones produced by the body, endogenous ketones to be exact.

Since the odorous issue is not an exclusive matter of hygiene, it cannot be resolved by a dentist, unless professional help is needed to remedy an underlying dental problem that could be contributing to bad breath.

Most often, it will need to be addressed with an adjustment to your macros, among other things.

For those of you missing carbs, this is good news: elevating carb macros slightly—maybe from 20g to 25g of net carbs a day—can also help to curb the strong presence of keto breath.

Ketones are an ever-present and naturally-occurring chemical produced by the body. However, a drastic reduction in carb consumption and high use of proteins in the diet can result in some less-than-pleasant breath.

Dieters who experience bad breath in ketosis are impacted by two factors that independently and at times collaboratively, contribute to halitosis: ketone release and excess protein consumption.

With these two factors at the heart of the matter, it’s vital to understand how they affect keto breath so we can then cover practical ways to keep things fresh on keto.

Ketone Release

In this context, and especially at first, our body’s fuel source of ketones, while in ketosis, appears to be both friend and pseudo-foe. Although ketones provide many health benefits, the bad breath they facilitate upon release when getting into ketosis might inadvertently clear our dating card for a couple of weeks; but luckily, keto breath is a temporary condition.  

Most on a Standard American Diet eat a large number of carbohydrates and simple sugars which the body converts to glucose for fuel. However, on keto—where carbs are reduced considerably which empties your glycogen stores—the body needs to access another fuel source.

When eating few enough carbs to achieve metabolic ketosis, likely via a ketogenic diet or a form of intermittent fasting, the body converts body fat to what are called endogenous ketones.

The increased amount of ketones produced by the body are then used as fuel with excess ketones released from the body via urination or respiration, so the body remains in balance, and only stores the energy it needs for optimal performance.

Most refer to keto breath as dominantly fruity and sweet, although decidedly unpleasant.

The body utilizes and releases three common ketones in ketosis: acetoacetate, beta-hydroxybutyrate (BHB), and acetone—with acetone said to be responsible for the distinct smell of nail varnish or nail polish remover that stays on a person's breath.

Protein Excess

Although ketones are a significant factor that contributes to sub-par breath on keto, their proverbial partner in crime is excess protein.

The macronutrient profile composition on any form of the ketogenic diet will rely majoritively on fat and protein, respectively. It can be beneficial to reduce protein and supplement those calories with fat-based options to curb the production of excess, odor-producing, ammonia and ketones when in ketosis.

An increase in protein consumption is an essential component in regards to keto breath because native oral bacteria produces what are known as volatile sulfur compounds (“VSCs”).

Those compounds are most abundant when the body breaks down the protein we consume, which can contribute to pungent breath that some describe as smelling similar to vodka, or conversely, acidic.

Bacterial Load

Again, keto breath is not necessarily an issue of oral hygiene, but one related to increased protein intake which will subsequently cause the body to produce elevated amounts of VSCs which creates an environment that encourages foul breath.

To that end, it’s even more important to remain diligent with a solid oral care routine when in ketosis.

You do have the ability to leverage a controllable variable in a situation that otherwise seems a bit challenging to control.

How Long Does Ketosis Breath Last?

We might apply the adage that nothing worth having comes easy; there are periods where we inevitably experience growing pains in pursuit of mastering a new lifestyle.

Our bodies also need time to adjust to running on fat for fuel, further evidenced by some of the other common symptoms people can experience when transitioning to a very low-carb, high-fat, ketogenic diet (a.k.a., the keto flu).

Fortunately, just as the headaches, lethargy and brain fog, often noted by those as they start keto, dissipate before long. Keto breath, like keto flu, is usually short-lived, a matter of weeks for most, and is something that you can probably power through with a not-so-out-of-reach end in clear view.  

Symptoms of Keto Breath

You are likely noticing the many benefits of being in deep ketosis, when a whiff that something’s off may arise. Some note a metallic taste in their mouth, and you may notice that your urine smells tart, acidic or even fruity.

All of the above are good indicators that you are in ketosis, as well. Even though you can’t smell your breath to know whether it’s less than fresh, applying the best practices noted here is a robust and proactive plan to maintain fresh breath while in ketosis.

Again, the persistence of keto breath will likely be short-lived and subside around the same time that keto flu symptoms wane, if you experience flu symptoms at all, that is.

Although it may be virtually impossible to avoid altogether, there are some steps we can take to tamp down any unpleasant oral odors associated with ketosis.

How to Stop Ketosis Breath

You may be so eager for this portion that you could be reading this first: if so, don’t worry, we understand your eagerness and will share the most effective ways to mitigate keto breath below:

Drink Water

It is essential to note that hydration is vital on a ketogenic diet—especially concerning oral health. Our bodies release increased amounts of water when we drastically reduce carbohydrates in our foods, and it is essential to focus on hydration for this reason.

But it’s equally important to remain hydrated every day to flush food particles from the mouth and avoid dry mouth, both of which can contribute to bad breath, even independent of ketosis.

Reduce Protein

This point is particularly relevant to those following more of an Atkins diet or the High-Protein Keto Diet (HPKD), as those protocols tend to encourage a higher percentage of daily protein which may make subscribers more susceptible to bad breath.

Here’s the thing, while a high-protein ketogenic diet may be ideal for athletes looking for the best version of keto to power their high-intensity activities, the benefits of HPKD may come at the cost of bad breath for a short period.

Make an effort to eat healthy fats with each meal to mitigate the effects of consuming large amounts of protein that trigger ketosis breath (e.g., acidic, like nail polish remover, sweet and fruity, etc.).

Temporarily Increase Carbs

Ketosis has many health benefits from aiding in rapid weight loss to acting as the building block for brain development and optimal cognitive performance.

However, you may want to increase carbs for a period to alleviate the intensity of keto breath. Plus, keep in mind, it is still possible to experience rapid body fat loss outside of metabolic ketosis without the odorous consolation prize of keto breath.

Cures for Ketosis Breath

Although it may be impossible to erase all evidence of ketones being released via urine and respiration, there are a few things we can do to put our freshest face forward.

The following are some tips to keep your breath a silent and respectful partner in life:

Improve Your Oral Hygiene

Again, oral hygiene is not the cause of keto breath as it is a unique form of halitosis directly associated with nutritional ketosis. However, staying on top of your oral hygiene can help calm the situation by preventing the overrun of bacteria which will generally cause malodor.

If you find that your regular twice-a-day brushing routine isn’t cutting it on keto, try adding some of these additional steps to your oral regimen:

Tongue Cleaning

The use of a tongue scraper is a great tool to clear any matter that might produce an odor. Scraping in addition to regular brushing is said to be twice as effective as just brushing alone, and is a fabulous tool to beat back bacteria.

Oral Rinses

Keep your mouth lubricated to prevent dry mouth, in addition to getting the aid of its antibacterial elements, with a homeopathic mouth rinse as a great way to suppress pungent breath.

Oil Pulling

This ancient method of impurity extraction is gentle but highly effective. Use organic, unrefined, cold-pressed coconut oil for its anti-bacterial benefits and swish it around in your mouth for 15-20 seconds. Once you eliminate the oil, you’ll also eliminate unwanted matter and bacteria from your tongue, teeth, and gums.

Flossing

It’s nothing new-age or particularly exciting, but it works! Floss daily to remove food particles that may wedge between the teeth and create an odor over time.

Drink More Water

This tip is excellent for your overall health, and as I mentioned before, that's even more so the case when on the ketogenic diet. Stay hydrated to prevent dry mouth which can encourage bad breath.

Also, drinking water throughout the day—especially water with fresh, organic lemon juice—keeps your palette clean, giving bacteria less of a chance to become problematic.

The more water you drink, the more you will flush away the smell of ketones on the breath and also dilute the smell of ketones in your urine, a definite all-around good way to go.

Add lemon to your water for additional antibacterial benefits that will also help to regulate oral Ph balance and support fresher breath.

While drinking a lot of water has various health benefits, it’s important to note that replenishing necessary nutrients as you increase water intake is vital because as water weight is flushed from the body, so are essential vitamins, minerals, and electrolytes.

Recalculate Your Macros

Consider slightly increasing carb intake (e.g., again, maybe from 20g to 25g net carbs per day), to see if fewer ketones in your body help freshen your breath, or try decreasing protein and increasing fat consumption.

Reducing the intake of protein will cut down on the amount of ammonia the body produces in the process of metabolizing the proteins we consume and can, therefore, reduce the emission of odor in our breath or urine.

It’s also important to remember to reevaluate your macros whenever you've lost a considerable amount of weight or alter your activity level or frequency dramatically.

Ultimately, many factors about who you are and your level of activity will all come together to determine your ideal macro range to achieve your health goals.

Swap in an avocado or a delicious and fatty piece of salmon over adding more protein into your meal plan; the healthy fat is great to keep you satisfied while eliminating excessive amounts of ammonia in your system, which may lead to fresher and more welcoming breath.

Natural Breath Fresheners

Try chewing on some fresh, organic mint or any other number of food-based options known for centuries to aid in freshening breath.

Those who favor using traditional foods as breath fresheners hail the effectiveness of spices and herbs like cinnamon, cardamom, parsley, and rosemary, to name a few, as a godsend.

You can add some of the noted odor-fighting foods to your diet to promote pleasant breath so you can return your focus and energy to the reasons you chose to embark on the sugar-free, ketogenic lifestyle in the first place.

Be Mindful of Sugar-free Sweeteners

You may be tempted to reach for any of the various sugar-free mints, gums, or candies to improve your breath but doing so could expose you to some undesirable ingredients that could derail your health efforts.

Steer clear of the following ingredients as they contain sugar alcohols that are known to spike insulin levels and counteract your efforts to regulate glucose:

• Sorbitol
• Maltitol
• Isomalt
• Aspartame
• Sucralose
• Saccharin
• Mannitol
• Lactitol
• Polydextrose
• Hydrogenated starch hydrolysates

What’s more, in addition to causing an unfavorable insulin response, the noted sweeteners may also cause bloating and cramping and possibly trigger increased sugar cravings and migraines—no good.

Mind Your Mints and Gums

Although using mints and gums can help improve breath, they can be an insulin-spiking powder keg, full of hidden sugars.

Be careful about reading the labels of the gums and mints you opt to use while in ketosis. The hidden carbs some varieties contain can kick you out of ketosis, which defeats the purpose.

Make a DIY Breath Spray

Battling lousy breath doesn’t have to be expensive. You can whip up a homemade DIY breath spray with herbs and spices that you probably already have in your pantry.

Use distilled water, cinnamon, and grapefruit and peppermint essential oils to create a mouth spray that can help regulate oral bacteria and fight bad breath.

Here’s a basic recipe you can use as a template. Once you make the base recipe, feel free to get creative and make unique mouth spray variations that suit you:

Ingredients:

• 1 cup water
• 1 teaspoon ground cinnamon
• 4 drops peppermint essential oil
• 4 drops grapefruit essential oil

Directions:

• Bring the water to a boil, and then remove from heat and set aside. Add the peppermint and grapefruit essential oils along with cinnamon. Cover, and let ingredients infuse for five to 10 minutes.
• Strain with cheesecloth, or a very fine mesh strainer, into a BPA-free bottle with a spray lid.
• Use as needed.

Although no one is lining up to experience the embarrassing symptom of keto breath, the good news is that it doesn’t last forever, probably a week or so for most people, and then the body adjusts to running on ketones.

Once the body can efficiently regulate its level of endogenous ketones and is better able to discern the body’s energy needs at any given time, ketones aren't present in excess in the body, so they are less likely to be released and expressed as lousy breath.

A combination of exercising, oral health best practices, staying hydrated, consuming odor-fighting herbs and seeds, and using keto-friendly mints and gum can all prove helpful as you begin to enjoy the many health benefits of ketosis.

I’d be remiss if I didn't highlight that you have established a significant level of ketosis even to experience keto breath, so hang in there with the knowledge that you are living in fat-burning mode.

Living in a state of ketosis can facilitate: rapid fat loss, lean muscle gain, improved physical performance and enhanced mental sharpness—in the end, it’s worth the struggle.

Again, remain consistent with a quality oral hygiene protocol and be patient. Keto breath eventually resolves itself for some as the body becomes better fat-adapted.

Others find they need to compound some of the tips noted to suppress the strong smell.

Even if you’re unable to close-talk with anyone for a couple of weeks, rest assured that implementing the tips we’ve shared above will find you enjoying all the benefits of ketosis, without the bummer of blistering, bad breath.

Resources

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858534/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633265/