One morning, your urine looks as cloudy as a British beach, another, as yellow as lemonade. And that smell? Whew! What’s your liquid output telling you? Read on...
The tint of your urine catches your attention, especially when it looks unusual. But are the colors in your toilet bowl something to worry about?
The fact is, knowing what turns urine different colors may be a fun party trick, but it's no diagnosis, says Elizabeth Kavaler, M.D., clinical assistant professor of urology at Weill Cornell Medical College in New York City and author of A Seat on the Aisle, Please! The Essential Guide to Urinary Tract Problems in Women (Springer).
“Urination is one of the most common body functions, so people focus on it and look for [meaning] in their urinary habits,” she says. “But most colors are of no concern.”
Still, urine color can clue us in to health habits, diet and serious conditions. We asked experts what’s behind the hues.
Light Yellow
What it reveals: If you’re looking at a lemonade knock-off, “it’s a fairly normal color,” says Michael Hyman, M.D., chief of urology at Providence St. Joseph’s Medical Center in Burbank, Calif.
The yellow comes from bile produced by the liver and excreted in urine.
“That’s part of the elimination of toxins,” Kavaler says.
When to be worried: “If it’s very light yellow, you may be overhydrated,” Hyman says. “But as long as you don’t have a major condition, like kidney failure, it’s not dangerous. Your body just gets rid of the extra fluid.”
Clear
What it reveals: Urine that barely colors the toilet water probably means you’ve been drinking a lot of fluids. The lighter the color, the more hydrated you are, Kavaler explains.
When to be worried: “Light urine’s no problem, except for overpeeing,” Kavaler says.
Of course, excessive hydration can lead to hyponatremia, which occurs when someone drinks so much liquid the body’s balance of sodium to water goes off-kilter, according to the Mayo Clinic. That can be deadly. (Other risk factors for hyponatremia include some medications and medical conditions, such as kidney disease.)
“The average healthy person needs about six to seven 8-ounce glasses of water a day,” Hyman says. “Some people walk around with a 2-liter bottle in their hands, but that’s overkill.”
So drink just enough to stay hydrated throughout the day, but don't overdo it.
Cloudy
What it reveals: If nothing else seems wrong in your body, don't worry about cloudy urine, says Hyman.
“One of the most common causes is phosphaturia – phosphate crystals that form when the acidity of the urine is low,” he says. With chronically high levels of phosphate crystals, you may get kidney stones, Hyman says.
If you're concerned, test your urine at home by collecting some in a paper cup and adding a capful of vinegar. If the cloudiness is caused by phosphaturia, the urine will turn clear, says Hyman.
If your urine is chronically cloudy, see your doctor, he says: It could be an infection [without symptoms] or a sign of other inflammatory conditions, and rarely, cancer.”
Other causes of cloudy urine? “A pocket of pus from an infection in the urethra,” says Stanley Silber, M.D., chief of the division of urology at Mercy Medical Center in Baltimore.
A discharge also can make urine cloudy, but our anatomy makes it tough to know if the source is the urethra or vagina.
When to be worried: If you have cloudy urine, burning or urgency, and are urinating frequently, you probably have a urinary tract infection (UTI), says Kavaler. “It’s very unpleasant but not dangerous.”
A UTI, usually caused by bacteria, can involve inflammation anywhere along the urinary tract, from your urethra (the tube that carries urine to the outside of your body) to the kidneys.
One in five women will have a UTI in her lifetime, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). And once you have one, you’re more likely to have another, says the NIDDK.
To find out if you have a UTI, see your doctor for a urinalysis. If you test positive, you’ll probably be prescribed an antibiotic at the lowest effective dose, says Kavaler.
Need relief before you get to the doc? Kavaler suggests Cystex [methenamine], an over-the-counter medication that relieves burning and quells bacteria production.
If you test negative for a UTI but still have symptoms, see your gynecologist. You could have a vaginal yeast infection, which are more common than a UTI in women, says Silber. It can also be cured with antibiotics.
Blue-Green
What it reveals: If you're seeing cooler tones in your urine, the culprit may be color-changing medications or vitamins.
“Blue or greenish urine is very common from over-the-counter drugs, such as AZO [phenazopyridine] or Prosed [methenamine], that reduce the burning discomfort from UTIs,” Hyman says.
If you've had medical procedures, such as X-rays or computed axial tomography (CAT) scans, that involve intravenous dyes, like methylene blue or indigo carmine, you might see a corresponding color in your urine.
Some multivitamins may also turn urine blue or green, says Kavaler. Taking too many B vitamins tinge it bright-green.
When to be worried: If none of the above causes explain the color, you may have a bacterial infection called pseudomonas. “If your urine is acidic, the bacteria will turn it greenish-blue,” Hyman says.
Check with your doctor – pseudomonas can be quickly treated with antibiotics.
Fluorescent Yellow/Orange
What it reveals: Did you have a lots of carrots today? Love beets? Popped vitamin C to ward off a cold? Then expect an orange or rosy glow in your urine.
If food and vitamins aren’t the cause, it might be drugs. Medications – including the antibiotic rifampin (Rifadin), blood thinner warfarin (Coumadin), some laxatives and chemotherapy drugs – may also dye urine orange. So can a urinary sedative such as phenazopyridine hydrochloride (Pyridium).
“It’s used for patients who have tubes in their bladder or urinary system,” Silber says.
When to be worried: A dark orange color bordering on brown could mean too much bile is being excreted into your urine, says Silber.
“That could be a liver or gastrointestinal problem,” he says. “If you’re not on Pyridium and your urine is dark orange, get to a doctor.”
Brown
What it reveals: Chowing down on fava beans, rhubarb or aloe might turn urine brown, according to the Mayo Clinic. So can some medications, such as antimalarial drugs, antibiotics, laxatives and muscle relaxants.
But brown urine could also suggest a liver problem, Silber says, such as hepatitis (an inflammation of the liver caused by a virus or toxins) or cirrhosis, a condition that damages liver cells.
Or the color could be caused by dried blood from the kidney, bladder or urinary tract, or from an infection or tumor, says Silber.
When to be worried: “If your urine is brown, definitely see a doctor,” he says.
Smelly
What it reveals: Urine normally doesn’t smell sweet – its odor is more like ammonia.
And if you've eaten asparagus lately? Then your pee smells like rotten eggs or spoiled cabbage.
That's because an enzyme breaks down the veggies into compounds – including the same ones a skunk emits – which also get excreted in the urine.
“But if it’s really smelly, think of infection,” Silber says. “Congealed blood can also cause pungent urine.”
When to be worried: If asparagus isn’t the cause, see a doctor.
“Ninety-nine times out of a 100, smelly urine means an infection,” says Silber, which can be treated with an antibiotic.
Pink, Red or Bloody
What it reveals: Blueberries and rhubarb may turn urine pink. So can medications like laxatives, some antipsychotics and an anesthetic called Propofol. More dangerous causes are deadly toxins like lead or mercury.
Or you could be bleeding from vigorous exercise. “This occurs [from] bruising of the kidneys from strenuous running or weight lifting,” Silber says.
Kidney stones, tumors, a serious infection and kidney or bladder cancer can also cause blood in your urine.
When to be worried: “If you ate beets and the next day your urine is red and you’ve never had a problem with red urine before, don’t eat any more beets,” Silber says. “If your urine isn't clear in 24 hours, see a doctor.”
Red urine is the most serious flare your urine can send up; it “requires an extensive workup,” he says.
A doctor will order an X-ray or CAT scan of your kidneys and then do a cystoscopic exam, inserting a scope into your bladder through the urethra to check for infection and tumors.
There’s an over-the-counter dip-stick test that can identify blood in your urine. “But those have a lot of false positives,” Hyman adds.
The bottom line is, if you're seeing red, “let a doctor tell you why,” Kavaler advises.
Health writer Dorothy Foltz-Gray is a frequent contributor to Lifescript.
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