What could be wrong if you drink a lot of water but urine smells strong ammonia?

Possible causes of strong ammonia smell in urine despite drinking a lot of water:

1. Urinary Tract Infection (UTI): A UTI can cause changes in the smell of urine, including a strong ammonia odor. Other symptoms of a UTI may include frequent urination, pain or burning during urination, cloudy or discolored urine, and lower abdominal pain.

2. Dehydration: While drinking a lot of water is generally recommended to stay hydrated, excessive water intake can sometimes lead to overhydration or water intoxication. This can dilute the concentration of substances in the urine, including ammonia, making its odor stronger.

3. Metabolic Disorders: Certain metabolic disorders, such as kidney disease, liver disease, or diabetes, can affect the body's ability to process and eliminate waste products, leading to a buildup of ammonia in the urine.

4. Diet: Consuming certain foods, especially those rich in protein, can increase the levels of ammonia in the urine. Foods high in protein, such as meat, poultry, fish, dairy products, and beans, can contribute to a stronger ammonia smell.

5. Certain Medications: Some medications, such as certain antibiotics, chemotherapy drugs, and pain relievers, can affect the way the body processes ammonia, potentially causing a stronger ammonia odor in urine.

6. Vitamin Deficiencies: A deficiency in certain vitamins, particularly vitamin B12, can contribute to a stronger ammonia odor in urine.

7. Chronic Kidney Disease (CKD): In individuals with CKD, the kidneys are not able to effectively remove waste products from the body, leading to a buildup of ammonia in the urine.

It is important to note that a strong ammonia odor in urine can be a sign of underlying health conditions that require medical attention. If you are experiencing this symptom, it is recommended to consult a healthcare professional for evaluation and appropriate treatment. They can determine the cause and recommend necessary steps to address it.