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1 If the liver is unable to break down the ammonia it is excreted in the urine.  Other diseases - Other common causes of the ammonia smell in urine are diabetes, metabolic disorders, sexually transmitted diseases, medications, vitamins, and nutritional supplements.
If your urine becomes highly concentrated â a high level of waste products with little water â urine odor may have a strong ammonia smell. Many foods and medications, such as asparagus or certain vitamins, can affect the odor of urine.