Table of ContentsView AllTable of ContentsCausesWhat to DoPrevention
Table of ContentsView All
View All
Table of Contents
Causes
What to Do
Prevention
Your breath smell can indicate a lot more than when you last brushed your teeth. For example, breath that has a fruity or acetone-like scent may be a sign ofketosisfrom your diet, excessive alcohol intake, or liver disease.
If you havediabetes, this scent can be a sign ofdiabetic ketoacidosis(DKA), a condition that can be fatal if not treated.In other cases, it can be a sign of liver disease.
Learn more about fruity breath—including when your fruity breath should cause you to seek out medical attention.
Verywell / Laura Porter
Causes of Fruity Breath
Ketosis From Your Diet
Modern fad diets like ketogenic diets are designed to help your body enter a state of ketosis, where it begins burning fat rather than glucose (blood sugar) for fuel. This process releases chemicals known as ketones, including acetone, which can cause a fruity smell. In fact, having fruity or acetone-smelling breath is a reliable sign that your body has entered ketosis.
Ketones are also released when you’re fasting. That’s because your body is burning fat for fuel, rather than blood sugar, just as it is during ketosis. Along with fruity breath, other symptoms you may experience on a ketogenic diet include:
Is Fruity Breath From Dieting Dangerous?If you have been intentionally fasting or eating a ketogenic diet, fruity breath is not a cause for concern—it’s just a sign that your body has entered ketosis.
Is Fruity Breath From Dieting Dangerous?
If you have been intentionally fasting or eating a ketogenic diet, fruity breath is not a cause for concern—it’s just a sign that your body has entered ketosis.
Diabetic Ketoacidosis (DKA)
Diabetic ketoacidosis, or DKA, is a complication of diabetes, especiallytype 1 diabetes.
If a person does not have enough insulin, their body is unable to convert blood sugar to glucose, which the body uses as fuel. Without glucose to burn, the body enters a severe form of ketosis, releasing enough ketones into the blood that the ketones begin poisoning the person.
Fruity breath is a common sign of DKA. Other signs include:
If untreated, more severe symptoms can appear quickly along with fruity-smelling breath:
Sometimes DKA is the first sign of diabetes in children or adults who haven’t yet been diagnosed.
DKA can progress quite quickly once it begins. If you begin vomiting or have other symptoms of DKA, contact your healthcare provider immediately or go to the emergency room.
Risk Factors
Risk factors for developing DKA include:
Alcoholic Ketoacidosis
In some cases, excessive alcohol use can cause ketoacidosis. However, the condition is more rare than DKA.
Along with fruity breath, other symptoms of this condition may include:
In order to experience alcoholic ketoacidosis, a person often has to drink large quantities of alcohol, while also being malnourished.
Hyperglycemic Hyperosmolar Syndrome (HHS)
Hyperglycemic hyperosmolar syndrome (HHS) is extremely high blood sugar that occurs in people with type 2 diabetes who don’t have their diabetes under control. It’s similar to DKA in that it can cause a diabetic coma or death if left untreated.
In most cases, people with HHS do not experience the same buildup of ketones in their blood that people with DKA experience. However, some buildup of ketones in the blood can occur with HHS, leading to fruity-smelling breath. Other symptoms may include:
If you believe you are experiencing HHS, contact a healthcare provider or go to the emergency room immediately.
Liver Disease
In some cases, fruity breath has causes that are not related to ketones. People with liver disease can experience fruity breath, but it’s a bit different.
Difference of Fruity Breath Related to Liver DiseaseWhile fruity breath related to ketones has an acetone-like scent, the fruity breath associated with liver disease is mustier.
Difference of Fruity Breath Related to Liver Disease
While fruity breath related to ketones has an acetone-like scent, the fruity breath associated with liver disease is mustier.
Bad breath related to liver disease is known as fetor hepaticus.Other symptoms of liver disease include:
People with liver disease have higher levels of certain chemical compounds, including acetone. The link between liver disease and fruity, musty breath is so strong that healthcare providers use breath smell as an indication of liver disease.
What to Do if You Have Fruity Breath
If you experience fruity breath after intentionally fasting or following a ketogenic diet, you don’t have cause for concern. Drinking more water may help control the fruity scent, but there’s no way to prevent it while following these types of diets. Gum and mints may help mask the scent.
If you have diabetes and have glucose testing supplies on hand, check your blood sugar. If it is 240 mg/dL (milligrams/deciliter) or higher, use an over-the-counter ketone test kit to check your urine for ketones every four to six hours. You should also test for ketones if you have any of the symptoms of DKA. Call your doctor if your ketones are moderate or high.
If you are unable to test your blood sugar and ketones, go to the emergency room.
Seek Medical AttentionIf you are experiencing unexplained fruity breath, especially if you have diabetes, it’s important to seek medical care. Other symptoms to watch out for include:Confusion or change in alertnessExcessive thirstVery high blood sugarVomiting
Seek Medical Attention
If you are experiencing unexplained fruity breath, especially if you have diabetes, it’s important to seek medical care. Other symptoms to watch out for include:Confusion or change in alertnessExcessive thirstVery high blood sugarVomiting
If you are experiencing unexplained fruity breath, especially if you have diabetes, it’s important to seek medical care. Other symptoms to watch out for include:
A Word From VerywellIf you have diabetes and are having a hard time dosing your insulin and managing your blood sugar, contact your provider. If you suspect you are experiencing DKA, do not try to treat it at home unless under a healthcare provider’s supervision. It’s best to get to the emergency room since it is treated with insulin and fluids usually through an IV in the hospital.—JAMIE JOHNSON, RDN, MEDICAL EXPERT BOARD
A Word From Verywell
If you have diabetes and are having a hard time dosing your insulin and managing your blood sugar, contact your provider. If you suspect you are experiencing DKA, do not try to treat it at home unless under a healthcare provider’s supervision. It’s best to get to the emergency room since it is treated with insulin and fluids usually through an IV in the hospital.—JAMIE JOHNSON, RDN, MEDICAL EXPERT BOARD
If you have diabetes and are having a hard time dosing your insulin and managing your blood sugar, contact your provider. If you suspect you are experiencing DKA, do not try to treat it at home unless under a healthcare provider’s supervision. It’s best to get to the emergency room since it is treated with insulin and fluids usually through an IV in the hospital.
—JAMIE JOHNSON, RDN, MEDICAL EXPERT BOARD
Preventing Fruity Breath
If you have diabetes, managing your blood sugars and taking your medications as prescribed can help reduce your risk of fruity breath.
Remember to eat well-balanced meals spacedthroughout the day. If you need help creating a nutritional plan to help control your blood sugar levels, ask your healthcare provider for a referral to a registered dietitian.
Nutrition for Diabetes
If you have fruity breath because you are fasting or following a ketogenic diet, there’s not a lot that you can do to prevent fruity breath. Staying hydrated and brushing your teeth thoroughly can help make the smell less noticeable.
Summary
Breath that has a fruity or acetone-like scent may be a sign of ketosis from your diet, DKA, HHS, excessive alcohol use, or liver disease.
If you’re intentionally fasting or following a ketogenic diet, you should expect fruity breath. You can drink plenty of water, brush your teeth more often, or use mints or gum to try to mask it.
If you have fruity breath along with more serious symptoms like excessive thirst, vomiting, or change in alertness, seek immediate medical attention, especially if you have diabetes. This can be a sign of DKA or HHS, both of which can lead to serious complications (including death) if left untreated.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Diabetes Association.Diabetes & DKA (ketoacidosis).Ruzsányi V, Péter Kalapos M.Breath acetone as a potential marker in clinical practice.J Breath Res. 2017;11(2):024002. doi:10.1088/1752-7163/aa66d3UChicago Medicine.Ketogenic diet: what are the risks?Centers for Disease Control and Prevention.About diabetic ketoacidosis.MedlinePlus.Alcoholic ketoacidosis.MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.Merck Manual.Acute liver failure.Johns Hopkins Medicine.Chronic liver disease/cirrhosis.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Diabetes Association.Diabetes & DKA (ketoacidosis).Ruzsányi V, Péter Kalapos M.Breath acetone as a potential marker in clinical practice.J Breath Res. 2017;11(2):024002. doi:10.1088/1752-7163/aa66d3UChicago Medicine.Ketogenic diet: what are the risks?Centers for Disease Control and Prevention.About diabetic ketoacidosis.MedlinePlus.Alcoholic ketoacidosis.MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.Merck Manual.Acute liver failure.Johns Hopkins Medicine.Chronic liver disease/cirrhosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Diabetes Association.Diabetes & DKA (ketoacidosis).Ruzsányi V, Péter Kalapos M.Breath acetone as a potential marker in clinical practice.J Breath Res. 2017;11(2):024002. doi:10.1088/1752-7163/aa66d3UChicago Medicine.Ketogenic diet: what are the risks?Centers for Disease Control and Prevention.About diabetic ketoacidosis.MedlinePlus.Alcoholic ketoacidosis.MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.Merck Manual.Acute liver failure.Johns Hopkins Medicine.Chronic liver disease/cirrhosis.
American Diabetes Association.Diabetes & DKA (ketoacidosis).
Ruzsányi V, Péter Kalapos M.Breath acetone as a potential marker in clinical practice.J Breath Res. 2017;11(2):024002. doi:10.1088/1752-7163/aa66d3
UChicago Medicine.Ketogenic diet: what are the risks?
Centers for Disease Control and Prevention.About diabetic ketoacidosis.
MedlinePlus.Alcoholic ketoacidosis.
MedlinePlus.Diabetic hyperglycemic hyperosmolar syndrome.
Merck Manual.Acute liver failure.
Johns Hopkins Medicine.Chronic liver disease/cirrhosis.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
