Keto Metallic Mouth: Causes And Remedies

A metallic taste in the mouth is a common symptom of ketosis, which is a metabolic state where the body burns stored fat for energy instead of carbohydrates. This can be caused by a low-carb ketogenic diet or fasting. While in ketosis, the body breaks down fatty acids and converts them into chemicals called ketones, one of which is acetone. This acetone is then excreted from the body through the breath, resulting in a fruity or nail polish remover-like odour, often accompanied by a metallic taste in the mouth.

Ketosis

Keto Breath

"Keto breath" is a common side effect of the ketogenic diet, often noticed within the first few weeks of starting the diet. It is characterised by a fruity or acetone-like smell, similar to nail polish remover, and is caused by the presence of ketones, specifically acetone, in the breath. Acetone is one of the ketone bodies produced by the liver from fat breakdown. This distinct odour can be identified by breathing into one's palm.

In addition to the fruity or acetone-like smell, some individuals may experience a lingering metallic taste in their mouth, which is the most commonly reported form of keto breath. This metallic taste may make the tongue feel weird and the teeth feel fuzzy. However, it usually resolves after a couple of days.

Causes of Keto Breath

When carbohydrates are restricted, the body undergoes a series of changes. The drastic reduction in carbohydrates leads to a depletion of glycogen levels. Glycogen is made up of glucose molecules derived from carb-containing foods. As glycogen stores are depleted, fatty acids are broken down and converted into ketone bodies, including acetone.

The body then eliminates these ketones through exhalation and urination, resulting in the distinctive odour of keto breath.

Managing Keto Breath

Although keto breath is temporary and should subside as the body adjusts to the diet, there are several ways to manage it:

• Maintain good oral hygiene by brushing teeth regularly, flossing, and using sugar-free mouthwash.
• Stay hydrated by drinking plenty of water. This helps flush out ketones through urination.
• Chew sugar-free gum to mask the breath and reduce feelings of hunger.
• Eat saliva-producing foods like celery and lemon to help clean out lingering bacteria.
• Slightly decrease protein intake as the breakdown of protein produces ammonia, which can contribute to pungent breath.
• Try natural remedies like gargling with lemon essential oil or sipping lemon water, as lemon has antibacterial properties that can help eliminate bad breath.

Other Considerations

While keto breath is harmless for most people, it can indicate very high ketone levels in individuals with poorly managed type 1 or type 2 diabetes, increasing their risk of ketoacidosis. Therefore, it is important to monitor ketone levels and consult a healthcare professional if concerned.

Oral bacteria buildup

A metallic taste in the mouth is a common symptom of ketosis, which is a metabolic state that occurs when the body burns stored fat for energy instead of carbohydrates. This can be caused by a low-carb and ketogenic diet, but it may also be a sign of oral bacteria buildup, infections, or exposure to certain chemicals.

To maintain good oral health and prevent bacteria buildup, it is important to practice proper oral hygiene. This includes brushing your teeth twice a day, flossing once a day, and using a sugar-free mouthwash. Regular dental check-ups are also important to monitor oral health and identify any potential issues.

In addition to oral hygiene, dietary choices can also impact oral bacteria buildup. A diet high in sugar and carbohydrates can promote bacteria growth, as these substances can be broken down into simpler sugars that the bacteria feed on. Therefore, reducing sugar and carbohydrate intake can help to control bacteria levels in the mouth.

While the keto diet can help reduce oral bacteria by lowering sugar and carbohydrate intake, it is important to maintain a balanced diet to ensure sufficient nutrient intake. The keto diet can be restrictive, and long-term adherence may lead to nutritional deficiencies and osteoporosis, which is a weakening of the bones. It is always recommended to consult with a healthcare professional before starting any new diet, such as the keto diet, to ensure it is safe and appropriate for your individual needs.

Dehydration

Drinking plenty of water is crucial for staying hydrated on the keto diet. It's recommended to drink enough water throughout the day and to make sure your electrolytes are in check. This is especially important if you're experiencing insomnia on keto, as dehydration can contribute to sleep issues.

The keto diet can also cause dry mouth, which is sometimes accompanied by a metallic taste. This is because the keto diet restricts carbohydrates, which are a primary source of energy for the body. When you reduce your carb intake, your body breaks down fatty acids and converts them into ketone bodies, including acetone. Acetone is excreted through the breath, resulting in "keto breath," which has a distinctive fruity or acetone-like odour.

While keto breath is a sign that your body has entered ketosis, it can also contribute to dehydration. As your body tries to get rid of excess ketones, it expels them through the lungs, urine, and sweat. By drinking more water, you can help flush out the ketones through urination, reducing their presence in your breath.

In addition to increasing your water intake, there are a few other ways to manage keto breath and the associated metallic taste:

• Maintaining good oral hygiene by brushing your teeth regularly and flossing.
• Chewing sugar-free gum to mask the breath and reduce feelings of hunger.
• Eating more protein, as excess protein produces ammonia, which can contribute to the unpleasant odour.
• Consuming saliva-producing foods like celery and lemon, as extra saliva helps to clean out lingering bacteria that can worsen the odour.

It's important to note that keto breath is usually temporary and should subside within a few weeks as your body adjusts to the new diet. However, staying properly hydrated and managing the metallic taste can make the transition period more comfortable.

Diabetic ketoacidosis

DKA is characterised by a rapid increase in blood acidity due to high levels of ketones. This condition is a medical emergency and can lead to severe illness or death if not treated promptly. The warning signs of DKA include high blood sugar levels, high ketone levels in the urine, excessive thirst, frequent urination, nausea, vomiting, stomach pain, weakness, shortness of breath, and fruity-scented breath. In more severe cases, individuals may experience confusion, loss of consciousness, and even cardiac arrest.

People with type 1 diabetes are at a higher risk of developing DKA, and it can sometimes be the first sign of diabetes in undiagnosed individuals. It can also occur in those with type 2 diabetes, but it is less common and usually triggered by uncontrolled blood sugar, missed medication doses, or severe illness or infection.

The treatment for DKA typically involves hospitalisation, where individuals receive insulin, fluids, and other treatments to correct high blood sugar levels and replace lost fluids and bodily chemicals. Early detection and management of diabetes are crucial to preventing and treating DKA effectively. Regular monitoring of blood sugar and ketone levels is important, especially when sick or experiencing stress.

While DKA is a serious complication, it can be prevented and treated with proper diabetes management, including healthy eating, physical activity, and adherence to medication regimens. It is important for individuals with diabetes to learn the warning signs of DKA and seek immediate medical attention if they experience any symptoms.

Medication

• Antibiotics such as clarithromycin, metronidazole, and tetracycline.
• Allopurinol, a gout medication.
• Blood pressure medications, including captopril.
• Lithium, used to treat psychiatric conditions.
• Methazolamide, a glaucoma medication.
• Metformin, a diabetes medication.
• Antidepressants, which can cause dry mouth and impact taste buds.
• Over-the-counter vitamins or medicines, such as multivitamins with heavy metals or zinc lozenges.
• Prenatal vitamins and iron or calcium supplements.

Additionally, medications that cause dry mouth can also lead to a metallic taste. It is important to note that dysgeusia can be a symptom of more serious illnesses, such as kidney or liver problems, undiagnosed diabetes, or certain cancers. However, these cases are usually accompanied by other symptoms.

Frequently asked questions