woman with arm raised showing underarm

What the Smell? Troubleshooting Common Keto Side Effects & How to Fix Them

keto common side effects smell – woman with arm raised showing underarm

Ever notice keto…kind of…stinks?

A high-fat, low-carbohydrate diet like the ketogenic (keto) diet has shown significant health benefits in many of those who dare to challenge traditional dietary guidelines. However, when first starting your fat-fueled journey, temporary adverse side effects may appear while the body is developing new machinery to burn that high octane fuel we call fat.

With a little patience and some minor tweaks, your body will adapt to being a fat burning machine and these side effects will often decrease or go away altogether.

The Smells — Dragon breath, B.O., and stinky pee

keto common side effects smell – peppermints with mint leaf in tin

Bad breath (a.k.a. dragon breath)

One of the 3 types of ketones our body produces when being fueled by fat is acetone — yes, that stuff in nail polish remover — but don’t worry, this is a normal part of general fat metabolism and a sign that ketosis is working. Excess acetone is excreted through breath causing that fruity, nail polish remover smell.


  • Drink more water. Dry mouth + keto breath = dragon breath! Adequate hydration will help produce saliva and keep any bacteria out of the mouth.
  • Swish peppermint oil. It may work better than mouthwash, but only masks the issue and doesn’t solve the problem.
  • Get moving. Increasing physical activity can burn off and use the excess ketones.
  • Smell ammonia? Ammonia comes from nitrogen, nitrogen comes from protein. If your smelling ammonia, you may be consuming too much protein.
  • Practice patience. Keto breath is a sign that you are not fully fat-adapted. Over time your body will adjust and start burning those ketones for fuel rather than spill them out, so pop a sugar-free mint and keep plugging along.

keto common side effects smell – shower head with water running

B.O. (Body odor)

New food, new fuel, new metabolism, and changes in hormones all may contribute to smellier armpits than normal… again, this typically will diminish and normalize after a few weeks of living keto.


  • Don’t skip the shower.
  • Pack on the deodorant.
  • Keep your arms down low.
  • And be patient.

keto common side effects smell – bathroom

Stinky pee (urine)

Similar to acetone, acetoacetate is another type of ketone that is excreted when unused. However, instead of through the breath, this ketone is spilled through urine. In the beginning, did you notice dark purple ketones on the urine strips, but only to have them mysteriously fade away after a few weeks? Good news, this means your body is adapting and has learned how to use those ketones for fuel!


  • Make sure your drinking enough water. FYI, urine ketone strips are affected by dehydration making the strips look darker due to concentrated ketones — please drink more water!
  • Oh, and did I mention, be patient? 

Bottom Line: Be patient, drink water, pop a sugar-free mint, take a shower, and keto-on!

Curious to learn more about keto? Check out our Start Here page.

Tara Finnerty RDN, CSP, CD—is a ketogenic specialist and fat-fueled enthusiast. Tara is a registered dietitian in Utah and owner of Sugar House Nutrition LLC. Her aim is to provide nutrition support for people wanting to reap the many health benefits of the ketogenic (keto) diet. Her expertise in the keto diet was initially working with children who have uncontrolled epilepsy. Tara supports nutrition diversity and works toward helping people find an individualized approach to make healthy eating sustainable.



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