The smell of acetone from the mouth

Some external changes in the body, such as the appearance of rash, discoloration, sputum, the appearance of odor from the mouth, have long been taken into account by doctors in the diagnosis of certain diseases. The appearance of an unpleasant acetone smell of urine, skin or from the mouth can serve as signs of various diseases: first or second type diabetes mellitus, acetonemic syndrome, heart problems, infectious diseases and other signs of ill health. The smell of acetone from the mouth of a child or an adult is explained by the complex mechanism of appearance, it usually does not depend on age. This is due to the increase in human blood ketone bodies: acetoacetic acid ( H3C-CO-CH2-COOH ) and β-hydroxybutyrate ( H3C-CHOH-CH2-COOH ).

The metabolic state, which is due to the high concentration of ketone bodies formed during the breakdown of fatty acids, is called ketoacidosis. This pathological state of metabolic processes is due to the fact that the body is not able to adequately regulate the production of ketones, as a result, keto acids accumulate and the pH of the blood changes. In extreme cases, ketoacidosis can be fatal. This metabolic state is most common in type 1 diabetes mellitus.

With long-term use of alcoholic beverages, alcoholic ketoacidosis occurs, and there is also a smell of acetone from the mouth, caused by the content of acetone in the exhaled air, which is a by-product of the spontaneous decomposition of acetoacetic acid. It is often described as the smell of a lacquer.

At a high concentration of glucose in the blood (hyperglycemia), caused by the lack of insulin (the first type of diabetes mellitus) or the inability of cells to respond properly to insulin (the second type of diabetes mellitus) leads to a further increase in the acidity of the blood. In healthy people, this usually does not happen, because the pancreas produces enough insulin, or the cells react properly to the hormone produced in sufficient quantity by the pancreas. As a result, glucose enters the cells (they do not go hungry), its concentration in the blood does not increase, and there is no reciprocal increase in the concentration in the blood of ketone bodies. Therefore, in healthy people (not suffering from diabetes), there is no smell of acetone from the mouth.

In diabetic patients, ketoacidosis is accompanied by hyperglycemia (high blood sugar in the blood serum) and dehydration (dehydration). An excess of glucose can lead to uncontrolled production of ketone bodies (through the metabolism of fatty acids), a condition in which there is a smell of acetone from the mouth of a child or an adult. As a result, there is an overload of the kidneys, in the urine, there is glucose (a phenomenon called glucosuria), which in a healthy body is absorbed by the kidney and returns to the bloodstream. Getting into the urine of glucose because of its increased concentration in the blood contributes to the loss of fluid. Diabetic ketoacidosis is potentially life-threatening for people with diabetes. This occurs predominantly in patients with type 1 diabetes, but may, under certain circumstances, occur in people with type 2 diabetes.

In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first stage of gluconeogenesis, the metabolic pathway leading to the generation of glucose from non-carbohydrate carbon substrates such as lactate, glycerin, and others. This is one of the two main mechanisms used by the human body and other animals to maintain blood glucose levels, which helps to avoid too low a fall (a condition called hypoglycemia). Other means of maintaining blood glucose level is glycogenolysis - processing of glycogen (reserve carbohydrate). If there is not enough glucose in the body to supply cells, an energy crisis is created, as a result of the response metabolism of fatty acids, ketone bodies are formed and there is a smell of acetone from the mouth.

Mild acidosis can be the result of prolonged fasting or ketogenic diets (the diet includes products containing a high percentage of proteins and fats with a low carbohydrate content), which in medicine are mainly used to treat hard-to-control epilepsy in children, cardiovascular diseases, chronic fatigue syndrome And other conditions. Low-carbohydrate diets prescribed for weight control and obesity treatment also limit carbohydrate intake. At the initial stage, such a diet of glycogen stores is enough, about a day. Then the body uses alternative energy sources (fats and proteins), in the decay of which ketone bodies are formed , and the smell of acetone from the mouth appears.