What the color of your pee says about your health

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From Netdoctor

Wondering what the color of your urine means? If we pay attention when we have a pee, we usually expect to see urine of different shades of yellow. It’s easy to see why green, yellow, or even blue urine can be alarming.

Dr. Juliet McGrattan explores why urine can transform all the colors of the rainbow and what it says about our underlying health.

What is urine?

The production of urine is one of the mechanisms that our body uses to get rid of wastes. The kidneys remove toxins and wastes from the circulating blood, then dissolve them in water to create urine.

Urine travels from the kidneys along tubes called ureters and into the bladder where it is stored, ready to be expelled when the “urge to pee” strikes. Urine is approximately 90-95% water.

The rest consists of:

  • Salts

  • Urea – formed from the breakdown of proteins

  • Creatinine – from the breakdown of muscle

  • Ammonia

  • Urobilin – from the breakdown of red blood cells.

Why is urine yellow?

The yellow color of urine is largely due to the presence of urobilin, also called urochrome. Urobilin, which is yellow, is produced when the body breaks down old red blood cells that are no longer needed.

How pale or dark yellow your urine is depends on how hydrated you are. Lots of water in the urine will make it appear lighter in color and conversely, insufficient amounts will mean it is more concentrated and darker.

Healthy urine is said to be pale straw in color and we should drink enough water every day to maintain it. Urine is always darker in the morning because it becomes more concentrated during the night when we are sleeping.

Unusual urine colors and what they mean

Sometimes the urine changes color and may surprise you and cause you to worry about what might have caused it.

Because urine removes waste products from the blood that has circulated throughout the body, a change in urine color can indicate a problem in various organs and systems.

Here are a variety of colors you might see and what they might indicate:

Red or pink urine

There are many causes of red or pink urine, from what you have eaten to infections and cancer. If you notice red urine with no obvious cause, you should always see your nurse or doctor.

Here are some of the potential causes of red or pink urine:

• Red foods, such as beets or rhubarb that color the urine.

• Urinary tract infection, where blood has leaked from the blood vessels in the bladder or kidneys.

• Kidney or bladder stones that scratch the delicate lining of the bladder, ureters, or kidneys when they try to pass through the system.

• Infection or inflammation of the prostate (in men)

• Menstruation – even a small drop of period blood can color urine pink or red

• Endometriosis – when the tissue that lines the uterus has also grown in the bladder

• Heavy exercise can sometimes cause blood loss from the bladder wall.

Brown urine

Brown urine can just mean severe dehydration, but there are other causes as well:

• Foods, especially rhubarb, broad beans, blackberries and aloe vera

• Dehydration can make urine darker; this may be due to excessive fluid loss due to sweating during exercise, fever, or insufficient fluid intake.

• Medicines, including the antibiotic metronidazole, antimalarials, and some laxatives.

• Rhabdomyolysis – muscle breakdown due to excessive exercise, dehydration and muscle trauma. It can also be caused by certain street drugs, seizures, and hereditary medical conditions.

• Porphyria, a rare metabolic disorder that can cause urine to be rusty brown in color because large amounts of porphyrins are excreted and stain urine.

• Old or “stale” blood is browner in color than fresh blood and can be the result of any of the causes of red urine listed above.

Orange urine

Again, orange urine may indicate that you need to drink more fluid or that you’ve eaten something orange, but it could be due to other, more serious issues:

• Food products, including carrots

• Dehydration can make urine orange.

• Medicines including warfarin, the antibiotic rifampicin and certain laxatives

• Liver problems. When there is a buildup of excess bilirubin from the liver, the skin may turn yellow (jaundice) and the urine may turn dark orange

Green urine

Green is a more unusual and surprising color for urine. This is usually temporary and for a simple reason, but it can be related to infections:

• Foods, such as asparagus or foods containing green dyes

• Dyes given in medical tests, eg kidney exams

• Medicines, including some used during anesthesia, eg propofol

• A urinary tract infection with the bacteria pseudomonas can produce urine tinged with green.

Yellow urine

The urine always looks yellow, but if it suddenly appears a very bright neon color, it may be due to the consumption of vitamin B supplements, especially vitamin B12. B vitamins are soluble in water, so you “pee” any excess that your body hasn’t used.

White urine

Urine may be a very pale, almost white color if you have drunk large amounts of water and the urine is very diluted. Cloudy urine can also appear milky white and this can happen due to:

• Urinary tract infection

• Heavy discharge from the vagina or penis producing white blood cells or mucus

• Sexually transmitted infections such as chlamydia and gonorrhea can produce cloudy urine.

• Infection or inflammation of the prostate

Purple urine

Striking purple urine can occur with a rare condition called purple urine bag syndrome (PUBS). It usually affects people with a long-term urinary catheter and UTI. The combination can result in dark purple urine.

Blue urine

Blue is a rare color for urine because when the blue pigment mixes with the yellow in urine, green is produced. However, blue urine can develop from:

• Foods with blue colorings

• Drugs, including indomethacin, amitriptyline and propofol

• Blue layer syndrome, an extremely rare inherited disease characterized by metabolic errors resulting in high levels of calcium in the blood and sometimes urine colored blue. It is usually detected in children.

• Urinary tract infection with the bacterium pseudomonas.

If you have concerns about the color of your urine and there is no obvious cause for the color change, you should see your nurse or doctor. It is helpful to take a freshly collected urine sample in a sterilized container with you to your appointment.

Last update: 26-08-2020

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