Acetone odor in urine: causes and what to do

If a person has no health problems, then his urine should not have any unpleasant foreign smell. Therefore, the smell of acetone in urine should always be a warning sign. Of course, it is not necessary to immediately assume the presence of a disease: it is necessary to undergo an examination - perhaps the smell of acetone in urine is associated with the nature of nutrition or previously taken medications.

Epidemiology

The smell of acetone in urine is diagnosed more often in women than in men (more than 3%).

Most often, the smell of acetone in urine is detected in young patients aged one to four years.

The smell of acetone in urine is considered the most common abnormality that is detected during a general urine test.

[ 1 ], [ 2 ], [ 3 ]

Causes of acetone odor in the urine

The smell of acetone in urine (in medicine – acetonuria) appears as a result of an increase in the number of ketone bodies in the urine. Ketone bodies are found in large quantities as a result of insufficient oxidation processes of lipids and proteins.

The presence of acetone smell in urine does not mean the presence of a disease in every person. There is even an indicator of the permissible content of ketone bodies - 25-50 mg / day.

The following risk factors may influence the development of acetonuria:

• improper nutrition, with predominant consumption of animal proteins;
• insufficient fluid intake, “dry” fasting;
• prolonged fever, protracted infectious diseases, dehydration;
• excessive physical exertion;
• taking medications that have an indirect effect on the urinary organs and pancreas.

The smell of acetone in urine in women is often associated with various diets that representatives of the fair sex try on themselves. For example, long-term protein and low-carbohydrate diets, as well as "dry" fasting can lead to the predominance of the smell of acetone in urine.

Additional reasons for detecting the smell of acetone in urine may include:

1. increased insulin levels in the blood;
2. fever;
3. viral diseases;
4. general anesthesia;
5. thyroid pathologies (thyrotoxication);
6. poisoning - for example, alcohol;
7. comatose and pre-comatose state;
8. extreme exhaustion of the body;
9. anemia;
10. serious problems in the digestive system (oncology, stenosis);
11. conditions associated with periods of uncontrollable vomiting;
12. gestosis of pregnancy;
13. head injuries.

• The smell of acetone in the urine of a child may be a consequence of improper functioning of the pancreas. The essence is that the formation of the child's digestive system occurs gradually and slowly. Due to certain factors, the gland may experience an unbearable load for it, as a result of which enzymes are produced incorrectly, which is manifested by the smell of acetone in the urine. Such reasons may be:
  • overeating, eating dry or on the run, frequent consumption of unhealthy foods with chemical additives and carcinogens;
  • fears, psycho-emotional stress, frequent overexcitement in a child;
  • uncontrolled use of antibiotics;
  • ARI, flu, acute respiratory disease, hypothermia;
  • allergic processes, helminths.
• The smell of acetone in the urine of an adult man can be caused by improper nutrition or pathological reasons:
  • diabetes mellitus;
  • alcohol intoxication, poisoning with phosphorus compounds, lead, etc.;
  • pre-comatose state;
  • stenosis of the digestive system, malignant tumors in the digestive organs;
  • the influence of chloroform;
  • head injuries.

In all situations, if such a smell appears in the urine, it is necessary to visit a medical specialist and undergo a full course of diagnostics.

• The smell of acetone in the urine of an infant is mainly associated with a violation of functional processes in the pancreas. The digestive organs of children improve up to the age of 12, so in the first months and years of a child's life, his digestive tract in most cases is not yet ready for stress. Early complementary feeding, overeating (too frequent or abundant feeding), too rich a composition of breast milk in the mother - any of these factors can provoke the appearance of the smell of acetone in the urine. In addition, other possible causes cannot be ruled out:
  • fear, excessive emotionality of the child;
  • overfatigue;
  • diathesis;
  • helminthic infestations;
  • antibiotic therapy;
  • overheating or hypothermia.

If a child smells acetone in his urine, then in no situation should you delay visiting a doctor. The sooner the cause of this condition is detected, the more favorable the further prognosis for the baby's health will be.

• The smell of acetone in urine during pregnancy most often appears during toxicosis - for example, with frequent vomiting and the inability to eat normally or even drink water. The woman's body becomes dehydrated, ketone bodies accumulate, which reveals itself as the smell of acetone in the urine. An additional provoking role is played by psycho-emotional stress, weakening of the body's defenses, nutritional errors, as well as the pressure of the growing uterus on the digestive organs - in particular, on the pancreas.
• The smell of acetone in the urine of women in the morning may be associated with a pronounced violation of the renal filtration function - in particular, with congestive pathology. Such stagnation can also occur due to the fault of the woman herself: strict diets, small volume of consumed liquid, fasting. An additional common cause may be a sedentary lifestyle, typical of most office workers. To eliminate the smell of acetone in the morning, which is caused by the listed reasons, it is enough to balance the diet, double the amount of liquid drunk, and establish sufficient physical activity.
• The smell of acetone from the mouth and urine in the vast majority of cases indicates the presence of diabetes mellitus - in this situation, you should immediately contact a doctor. With diabetes mellitus, the amount of sugar in the blood steadily increases, but the cells experience a deficiency, because sugar cannot penetrate into cellular structures due to insulin deficiency. To solve the problem of imbalance, the body begins to break down fats - as a result, the level of acetone rises.

A strong, sharp smell of acetone in urine in diabetes can be caused by both high and low blood sugar levels. Therefore, in order to prevent an increase in the concentration of ketone bodies and not cause the development of a coma, patients with diabetes must constantly and carefully monitor their glucose levels.

[ 4 ], [ 5 ]

Pathogenesis

In adult patients, the smell of acetone in the urine in most situations is caused by diabetes mellitus type II, which is especially common in people prone to obesity. The walls of the cells contain a large amount of fat, and with a general increase in body weight, these walls thicken and lose sensitivity to the action of insulin. As a rule, in such a case, in order to cure a person of such diabetes, doctors recommend normalizing weight and eating foods with a limited content of simple sugars.

In addition, the smell of acetone in the urine of an adult can also occur for other reasons - for example, with sudden weight loss, oncology, thyroid disease, when following overly strict diets, or when fasting.

The smell of acetone in a child's urine may be caused by a condition called acetonemic syndrome. Many people confuse this syndrome with diabetes, but these are not equivalent concepts. Acetonemic syndrome is a reversible process that occurs due to errors in the child's nutrition, viral and bacterial infectious pathologies, fatigue or stress. If the cause of this syndrome is eliminated, the smell of urine will soon return to normal.

[ 6 ], [ 7 ]

Symptoms of acetone odor in the urine

If the smell of acetone in urine is associated with a disease such as diabetes, then the first signs will indicate a change in the blood sugar balance:

• thirst and dry mouth will appear;
• you will be bothered by frequent urge to urinate, the amount of urine excreted will increase;
• the skin will become dry and dehydrated.

Only 2-4 days after the first signs appear (in the absence of the necessary treatment) other symptoms are detected, indicating increasing ketosis:

• signs of general intoxication with acetone compounds (bouts of nausea and vomiting, a strong smell of acetone from the mouth and in the urine, frequent shallow breathing);
• signs of intoxication load on the central nervous system (headaches, apathy, mood instability, development of pre-comatose and comatose states);
• signs of abdominal pathologies (pain and colic in the abdominal cavity, dyspepsia, tension of the abdominal wall).

If the smell of acetone in urine is associated with any other disease or condition other than diabetes, then the first signs will correspond to the clinical picture of the underlying disease.

Complications and consequences

Acetone or ketones in urine do not pose a particular danger to the human body. Normally, a certain amount of these substances is necessarily present in the blood and urine. This amount depends on the nutritional characteristics, general health indicators, and the level of psycho-emotional stress.

However, the constantly increasing level – ketoacidosis – can end in the development of a comatose state, during which the blood sugar level exceeds 13 mmol per liter, and ketones reach a mark of more than 5 mmol per liter, which can be toxic to the brain. The combination of high acetone levels with increased blood glucose is considered very dangerous and requires immediate medical correction.

[ 8 ], [ 9 ]

Diagnostics of acetone odor in the urine

In order to objectively assess the presence of acetone in urine, you need to take laboratory tests. In the pharmacy network, you can buy special test strips with which you can independently measure the level of ketones. They are sold without a special prescription. Such strips are impregnated with a special composition that changes its color when in contact with acetone. Two minutes are enough to evaluate the results. At the same time, the most unsafe value on the test strip is considered to be 15 mmol - if this happens, you should visit a doctor as soon as possible.

The most popular test strips are:

• Uriquette;
• Ketogluk;
• Ketophane.

It should be noted that the smell of acetone in urine is not yet a pathology, but only an indirect sign that can indicate both a disease and a specific deficiency state of the body. Therefore, various methods may be required for diagnosis, depending on what disease is suspected.

Thus, the doctor may prescribe additional tests: blood biochemistry, general blood and urine tests, determination of sugar levels, coprogram (to assess the functioning of the pancreas and liver).

Instrumental diagnostics are limited mainly to ultrasound examination of the abdominal cavity, urinary organs, and thyroid gland.

Differential diagnosis

Differential diagnostics when the smell of acetone appears in urine should be carried out between all diseases in which this symptom occurs. The doctor should carefully collect anamnesis, taking into account the patient's diet, lifestyle, etc. First of all, the doctor excludes the presence of diabetes mellitus, endocrine diseases, kidney diseases.

Treatment of acetone odor in the urine

Treatment should not be prescribed before a definitive diagnosis has been made. To get rid of the smell of acetone in urine, it is necessary to know the exact cause of this phenomenon.

Often, to normalize the quality of urine and eliminate the smell of acetone, it is enough to adjust your diet and daily routine.

Correction of the daily routine implies the establishment of high-quality and full sleep, mandatory presence of physical activity - for example, in the form of walking or morning exercises. If the smell of acetone in the urine was detected in a child, it is very important not only to provide the child with normal physical activity, but also to sharply limit the child's time in front of the TV and computer. Unbearable physical and mental stress is not recommended: it is better to exclude additional school activities and training for a while.

When considering sports, preference should be given to athletics and swimming.

The dietary correction should look like this:

Not recommended:	Recommended:
Lard, fatty meat. By-products. Fatty broths. Pickled products. Heavy cream. Chocolate, coffee, cocoa. Citrus fruits.	Vegetables, greens, fruits. A small amount of honey and homemade jam. Porridge. Vegetable broth. Biscuits, crackers. Weak tea, jelly, compote.

You should avoid processed foods, carbonated drinks, canned goods, chips, and fast food restaurants. Proper nutrition largely determines the quality of treatment, so you should not neglect it.

Medicines

Adsorbent preparations	To eliminate the main symptoms of intoxication, use: activated carbon in the amount of 10-30 g at a time, with a large amount of water, enterosgel 1 tbsp. with a glass of water, three times a day. Caution: if you overdose on the listed drugs, you may have difficulty with defecation.
Solutions replacing fluids	It is used to restore acid-base balance: rehydron is taken at 5-10 ml/kg of weight, isotonic sodium chloride solution is administered by injection intravenously from 20 to 100 ml per day/1 kg of weight.
Antiemetics	Cerucal, Metoclopramide normalize the tone of the digestive organs. Take in tablets of 10 mg up to 4 times a day. Antiemetics can affect the course of the menstrual cycle in women, as well as cause changes in blood pressure.
Polyphepan	Prescribed for intoxication, dyspepsia, lipid metabolism disorders - 1 tbsp. up to 4 times a day, with water. It is not recommended to take vitamins simultaneously with Polyphepan, as they may not be absorbed sufficiently.
Vitamins	Complex preparations – Alphabet Diabetes, Doppelherz Active, Gepar Active, Oligim, Blagomax – help regulate metabolic processes, strengthen immunity. Take according to the instructions.
Methionine	A hepatoprotector prescribed for toxic liver damage, poisoning (including alcohol poisoning). The standard dose is 0.5-1.5 g 0.5-1 hour before meals. Methionine has a specific smell and taste, which can cause a gag reflex in some patients.

Physiotherapy treatment

If the smell of acetone is detected in the urine, physiotherapy can only be used once a definitive diagnosis has been made. The goal of such treatment is to improve metabolic processes, prevent vasoconstriction, and accelerate peripheral circulation. At the doctor’s discretion, the following procedures may be prescribed:

• Intensive thermal effects – paraffin and mud applications, sollux – accelerate metabolism and improve tissue trophism.
• Syncardial massage (synchronous cardiac massage) – 10-15 minutes daily for two weeks.
• Diadynamic currents with two-phase fixed modulation – 100 Hz.
• Electrophoresis of vitamins (nicotinic acid 0.25-0.5%), UHF therapy.
• Balneotherapy – alkaline, sulfate and hydrogen sulfide baths.

If the smell of acetone appears in the urine, it is not advisable to carry out UV irradiation, use electrophoresis with novocaine, or use pulsed currents - at least until the underlying disease is determined.

Folk remedies

• An infusion of birch buds is prepared: 1 tbsp. of buds is infused in 500 ml of boiling water for several hours. Take 100 ml three times a day.
• Brew 15 g of bay leaf in 150 ml of boiling water, leave for an hour. Take 50 ml three times a day.
• Grind 500 g of lemons with peel, 150 g of garlic and 150 g of parsley in a meat grinder. Keep the mixture in the refrigerator for 14 days, then take 1 teaspoon 30 minutes before each meal.
• Drink compote made from blueberries and mulberries throughout the day, at least 3 times a day.
• Fresh Jerusalem artichoke tubers are eaten daily – 1-2 pieces.
• Include boiled green buckwheat in the diet.

Traditional healers recommend adding garlic, horseradish, beets, beans to dishes, and also drinking more liquids - in addition to plain drinking water, you can prepare herbal teas and decoctions.

[ 10 ]

Herbal treatment

Herbal treatment can be used as an aid when the smell of acetone appears in urine. Medicinal plants go well with diet, as well as with many medications that are taken under the supervision of a doctor.

From the huge list of herbal remedies, it is recommended to give preference to the following herbs and plants:

• blueberry leaf - take in the form of an infusion of 100 ml up to five times a day before meals;
• strawberry leaf - brew and drink instead of tea, one cup once a day;
• oats - infusion (100 g of oats per 600 ml of boiling water) drink 100 ml four times a day before meals;
• dandelion root, nettle leaf - take in the form of an infusion of 100 ml three times a day before meals;
• black elderberry leaf - prepare a decoction and drink 150 ml throughout the day;
• burdock rhizome - drink in the form of an infusion, 1 tbsp. up to 4 times a day;
• horsetail herb, knotweed herb - take 400 ml of infusion per day.

Other plant components also have a normalizing property that regulates metabolic processes in the body: ginseng rhizome, leuzea extract, zamaniha tincture, eleutherococcus extract.

If your urine smells of acetone, fresh juice from potatoes, white cabbage, raspberries, pears and dogwood will also help.

Homeopathy

Homeopathy helps to normalize blood glucose levels, improve blood quality, cleanse the urinary system, and support the body's functional abilities. Dosages of drugs are prescribed individually, depending on the patient's constitution, age, and underlying disease.

• Aconite – will help if the smell of acetone in urine is caused by diabetes.
• Secale cornutum is prescribed for vascular pathologies.
• Cuprum Arsenicosum – eliminates excess ketones in urine.
• Fucus - used if the smell of acetone in urine is caused by alimentary reasons.
• Bryonia will help if the smell of acetone in urine appears as a result of stress and phobias.
• Argentum nitricum is prescribed for unbalanced and improper nutrition.
• Iris is used for pathologies of the endocrine system.
• Echinacea – helps eliminate ketonuria.
• Acidum lacticum – used for diseases of the urinary system.
• Calcarea fluorica – prevents the development of diabetic glomerulosclerosis.

Surgical treatment is usually not performed when the smell of acetone appears in the urine.

Prevention

To prevent the appearance of acetone smell in urine, it is very important not to forget about an active and healthy lifestyle.

• Moderate physical activity will help stabilize lipid and carbohydrate metabolism.
• Contrast showers and swimming help to harden and improve metabolism.
• A good night's sleep of 7-8 hours a day will provide the body with sufficient rest and recovery.
• Walking in the fresh air will strengthen the body, increase immunity and prevent anemia.
• Proper drinking regimen with sufficient amount of liquid will prevent dehydration and help avoid the appearance of acetone smell in urine.

You should avoid stressful situations, do not overcool or overheat in the sun. If the smell in the urine appears again, then you should conduct diagnostics of the whole body at least 2 times a year.

[ 11 ], [ 12 ]

Forecast

The smell of acetone in urine always indicates some problem in the body: to clarify the cause of this unpleasant phenomenon, it is necessary to conduct a thorough diagnosis. Therefore, a doctor's consultation should be mandatory. If you seek medical help in a timely manner, you can avoid many complications and adverse effects.

[ 13 ]