Ammonia smell in the nose: causes and treatment

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Shutofedova Ksenia Yurievna

General practitioner

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Our body can tell us about its condition in many ways. One of them is smells. Every person intuitively or quite consciously knows which odors are inherent to him and which are unusual. The smell of ammonia in the nose can cause suspicion in anyone, because normally a person cannot emit such an “aroma.” In this article, we will figure out what causes the smell of ammonia in the nose and what to do if you notice such aromas.

What is acetone syndrome or acetone in a child?

The first thing to remember: acetone in a child is not a disease (not associated with a viral or bacterial infection), but a signal that the body has run out of glucose and there is an excess of ketone bodies in the blood. Ketones are a group of substances formed in the liver, products of incomplete oxidation of fats in the form of acetone and similar compounds.

How does acetone occur?

A child’s body is structured the same as an adult’s, but individual organs are not yet working at full capacity. Carbohydrates obtained from food are processed in the stomach and glucose enters the blood, most of which is used for energy, and some accumulates in the liver in the form of glycogen.

The supply of glucose (glycogen) in both adults and children is actively consumed with increased physical and mental stress, but in children it is much less, so it runs out faster. Fats are used, the breakdown of which also produces a small amount of energy, but at the same time ketones appear. If the child’s body does not receive glucose on time, fats will begin to break down too actively, and a large amount of ketones will be formed.

Quickly spreading through the blood throughout the body, they poison it. Acetone irritates the vomiting center and causes constant (acetonemic) vomiting, the smell of acetone appears on the breath and acetone in the urine, and there is a danger of dehydration.

What contributes to the appearance of acetone in a child’s urine and blood?

The main reasons for acetone:
• unbalanced diet
  - predominance of fats and proteins in the child’s food and lack of glucose;
• overeating and starvation;
• enzymatic deficiency
  - carbohydrates are poorly absorbed;
• increased glucose consumption
  - increased physical and mental stress, stress, injury, infectious diseases, especially accompanied by diarrhea and vomiting.

Olfactory hallucinations

Sick and recovered patients suggested that the smell of ammonia in the nose during coronavirus is a consequence of the immune system, its response to a viral attack. However, scientists refute this point of view, putting forward several theories.

According to virologists, ammonia and other strange aromas are delayed consequences of an infection. Information about such a post-Covid effect began to appear over the past two months, when the second wave began.

Research, the findings of which were published by the American publication JAMA, showed that in half of those infected with coronavirus, their sense of smell was fully restored a month after recovery. 40% of patients noted a noticeable improvement during this period, another 10% did not record any changes.

1 theory

Chief Researcher of the Research Institute of Clinical and Experimental Medicine A. Chepurnov stated that “Covid-19 is a very insidious disease that affects all organs, including nerve endings. This leads to distortion of odors. Not all patients experience the problem of odors, and the causes of the symptom are not yet fully understood. There is a version that this is how the nervous system is restored.”

2 theory

A version has also been put forward about the coronavirus’s effect on blood vessels, as a result of which the outflow of blood from the brain slows down and venous blood stagnates. The capillaries expand, putting pressure on the olfactory bulb with many nerve branches responsible for sensitivity to odors.

Neurologist, Candidate of Medical Sciences, head physician of the special care center Niomed R. Popovich said:

– There is a special term for this phenomenon – olfactory hallucinations. The symptom is not always harmless, and you can’t let things take their course. Especially if a lot of time has passed since the coronavirus, and your sense of smell still hasn’t returned.

It is better to consult a neurologist, since distortion of aromas is characteristic of many other pathologies, including oncology and the early stages of schizophrenia.

3 theory

M. Shipunov, head physician of the immunopathology clinic of the Research Institute of Fundamental and Clinical Immunology, believes this:

– Covid-19 damages the immune system so much that its cells begin to produce not only antibodies to this infection, but also to their own cells, including nerve cells. In fact, the body begins to fight with itself, and it takes time to restore the nervous system. Moreover, this will take a different time for each person, and it is impossible to predict even an approximate time frame for when everything will return to normal.

Thus, in scientific circles there are many possibilities to explain the ammonia odor. Most often it disappears on its own, but the process can be accelerated with the help of medications and other methods.

Diagnosis of acetone syndrome

The first signs appear at the age of two or three, by the age of seven or eight they can become more frequent, and at the age of 12-13 they usually stop.

If a child has acetone for the first time, it is necessary to contact a pediatrician, for example, a medical specialist. Acetone syndrome can only be determined by a doctor, since the smell of acetone in the urine may be a sign of insulin deficiency, and there is a risk of diabetes mellitus. In these cases, an urgent consultation with an endocrinologist, gastroenterologist and psychotherapist is required, which can be obtained here in the center.

Acetone in children can be divided into two types:
• primary - the result of poor nutrition and a sign of an unhealthy lifestyle;
• secondary - consequences of infectious and endocrine diseases, damage to the central nervous system.

In addition, there is a primary idiopathic acetonomy syndrome, where the main provoking factor is a hereditary predisposition.

In what diseases is it observed?

It has been established that the smell of acetone can occur in the following diseases:

• poisoning;
• coma;
• kidney inflammation;
• kidney failure;
• hepatitis;
• cholecystitis;
• dehydration due to intestinal infections;
• diabetes;
• liver injuries.

When an unpleasant odor begins to bother you, you should make an appointment with a therapist. After examination, questioning and studying the test results, the doctor will be able to refer you to a specialized doctor - gastroenterologist, endocrinologist, neurologist, nephrologist.

If such a symptom appears, the doctor will definitely prescribe a blood and urine test for diagnostic purposes. Additionally, nasopharyngeal culture and CT may be required. The research results will help identify the cause and select the optimal treatment regimen.

What causes the smell of ammonia in the nose?

A smell in the nose can appear due to various reasons, which implies a variety of mechanisms for the occurrence of this symptom. We point out the fact that the feeling of acetone in the nasal cavity is not a problem, but a consequence of the presence of some pathology. The sensation of acetone and ammonia can be caused by many ailments, which we will discuss below.

The first mechanism of action is associated with the development of pathogenic microflora in the nasal cavity. The human mucosa is populated by an abundance of microorganisms. While the immune system is strong, it easily restrains the growth of our single-celled “friends”, preventing them from growing. But when the immune system fails, bacteria begin to actively multiply, producing a huge amount of their own waste products into the nasal cavity. Many of them may smell unpleasant.

• If the cause of the unpleasant aroma lies in bacteria, then both you and those around you will feel this smell in your nose;
• If the smell is heard only by you, but others cannot hear it, then there is a disorder of smell. There are many reasons: injuries, abuse of vasoconstrictors, colds, acute respiratory viral infections with a runny nose, and so on.

Acetone breathing from the nose appears in another case - when the concentration of acetone in the blood increases above normal. This occurs in only about 10% of cases and the reasons for this phenomenon

Let's talk further. Most often, when a person complains of the smell of ammonia from the nose, the doctor suspects diseases of the nasal cavity (80%) and oral cavity (10%).

Cases have been recorded when the smell of acetone does not haunt a person all the time, but only in certain situations or at a specific time of day. And sometimes this is nothing more than a hallucination - with brain damage and some mental illnesses this is possible.

When we are talking about a child, it is possible that a foreign body could get into the nose and the body reacts to this aspect in this way. Actually, this can also happen with adults.

We recommend reading: Snot on the back wall of a child.

Children's multidisciplinary medical center for children from 0 to 18 years old

09/13/2017 Acetone in the urine (acetonuria) in a child appears as a result of a large accumulation of ketone bodies in the blood. When their concentration becomes high, they begin to accumulate, after which the kidneys themselves excrete them along with the urine. This condition can be caused by a violation of fat metabolism and a dysfunction of carbohydrate absorption.

The synthesis of ketone bodies occurs in the liver; they play an important role in the human body; with their help, body function is normalized and the energy source is replenished.

The level of acetone in urine is considered normal and safe - 1-2 mg per 100 ml of urine, in the daily volume of urine - 0.01-0.03 grams.

During normal operation of all systems and organs, ketone bodies are excreted in the urine and are not retained in the blood. An increase in the level of acetone in the urine can indicate temporary disorders in many healthy children, and also indicate the presence of a disease and pose a threat to the baby.

Reasons for increased acetone in urine:

In most cases, acetonuria in children is explained by the immaturity of the enzyme system, as well as other physiological factors, which include:

- hypothermia or overheating; - dehydration of the body; - prolonged fasting, low-calorie diet, poor in carbohydrates; - poor nutrition with a lot of fats and proteins; - binge eating; - constant stress, overwork; - long journeys.

There are also more serious reasons for the appearance of acetone in the urine:

- infectious diseases accompanied by an increase in body temperature to high levels, vomiting, loose stools; — diabetes mellitus, other diseases associated with metabolic disorders; - exacerbation of chronic diseases; — intoxication due to food and other poisoning; - injuries, etc.

Symptoms of increased acetone in the urine:

- increase in body temperature to high levels; - pain, abdominal cramps; - diarrhea, nausea, less often - vomiting; - lack of appetite, refusal to drink; - pale skin, shadows under the eyes; - lethargy, drowsiness of the child; - smell of acetone on breath.

If you do not seek medical help in time and do not eliminate the provoking factors, the situation may worsen and lead to acetone syndrome.

Acetone syndrome is a complex of symptoms that appear when the level of acetone in the urine increases.

Manifestations of acetone syndrome:

• frequent and profuse vomiting (episodes of vomiting can be observed from several hours to several days, vomiting is repeated at regular intervals, with the same intensity);
• the presence of bile and mucus in the vomit, less often - blood;
• severe dehydration of the body;
• cardiopalmus;
• deep noisy breathing;
• lethargy;
• photophobia;
• signs of intoxication: pale skin (but cheeks turn red), weakness;
• increase in body temperature from low-grade to high levels;
• drowsiness, convulsions, risk of coma;
• strong odor of acetone in exhaled air and vomit;
• stomach ache.

If the above symptoms appear, you should immediately seek medical help.

Diagnosis of acetonuria

If symptoms of acetonuria occur, or the smell of acetone appears from the child’s mouth (from urine), it is necessary to conduct an examination, including: a complete blood test, a general urine test, a biochemical blood test (total protein, glucose). Also, the level of ketones in urine can be determined at home, using special test strips.

Children suffering from acetone syndrome are recommended to regularly undergo the following examination: ultrasound of the abdominal organs, laboratory tests of urine and blood, and a test for glucose absorption every six months.

Diet for elevated levels of acetone in urine

If a child has at least once experienced an increased concentration of acetone, then in the future it is important to adhere to certain rules in the baby’s diet:

— foods that can increase the level of blood ketones are removed from the child’s diet: fatty meats, fish, rich broths, mushrooms, citrus fruits, fatty sour cream, cream, smoked meats, offal, tomatoes, sorrel, products containing cocoa, chips, gas water, fast food.

- recommended porridges cooked in water (rice, buckwheat, oatmeal, corn), soups with vegetable broth, lean meats (steamed), fresh fruits, sugar, honey - within reasonable limits, cookies.

Still have questions? Make an appointment with a pediatrician!

Phone number for making an appointment

How is excess acetone formed in the body?

If the body is not working properly, there are abnormalities in the periodontal tissues, bleeding gums, you need to contact a periodontist. In such patients, weakness of the ligamentous apparatus of the teeth may occur. Modern periodontology deals with strengthening gum tissue, eliminating bad breath and loose teeth. Treatment of receding gums is carried out, as a result of which the exposure of the necks of the teeth is eliminated.

When fats break down, acetone can form in the remaining substances. It enters the human bloodstream. In such a situation, increased removal from the body begins. It happens that the internal cleaning mechanism does not cope with this job. Then your breath smells like acetone. Both adults and children can suffer from this. Provoking factors are a deficiency of a useful substance, a pathological process. Toxic ketones accumulate in the body, which poison it. Ammonia is excreted not only through the lungs, but also through the kidneys. This means that its content in the urine will be increased, and when you breathe, you will feel an unpleasant odor in the mouth.

Other reasons

The reasons can be very different. One of them is diabetes. Problems with the liver and kidneys cause similar symptoms.

In this case, it becomes difficult to remove processed products from the body and intoxication begins.

• Smells in the nose: causes, possible diseases, treatment methods, reviews

The ammonia smell literally permeates every cell of the body.

Naturally, a person begins to feel it everywhere.

Important! The smell of acetone can accompany people actively engaged in weight loss.

The fact is that when fatty tissue breaks down, it forms two main compounds: glucose and ammonia. During intense training or other methods of sharply burning a large number of calories, a person may well feel an unpleasant odor.

How to get rid of it

Ideally, you need to see a doctor who will prescribe neuroprotectors and vitamin-mineral complexes. To speed up the regeneration of nerve endings, Glycine, which is easily found in every pharmacy, and B vitamins can be used.

The doctor must select the appropriate dosage, taking into account the patient’s complaints.

The ammonia aroma disappears when the infection is completely cleared from the body. This means that the normalization of the sense of smell is a sure sign of final recovery.

If ammonia vapors interfere with eating food that seems foul-smelling, you can switch to fresh foods - potatoes, rice. As a last resort, try protein shakes, which are prepared for athletes from special mixtures, but without flavoring additives or flavorings.

Doctors advise temporarily avoiding foods with strong flavors – in particular:

• fried meat and poultry;
• concentrated sauces and marinades;
• fresh garlic and onions;
• chocolate;
• products containing mint and menthol (including chewing gum).

It is also advisable to refrain from visiting stores selling perfumes and household chemicals, construction sites and shopping centers. It is better not to visit baths and saunas because the air is too dry, irritating the nasal mucosa and prolonging its recovery period.