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Urine Examination

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  • Urine has been an important diagnostic tool for 6,000 years, as well as having some surprising historical uses
  • You can learn a great deal about your overall health by examining your urine and noting its color, odor, and consistency, your urine can be a powerful window into your overall health
  • Urine color and odor can be altered by your diet, medications, supplements, water consumption, and physical activity
  • Your urine characteristics can also function as an early warning system for serious health problems including urinary stones, infections, kidney problems, metabolic disorders, diabetes, pituitary disorders, and even tumors
  • Frequency of urination is also important; increased urination may suggest infection, overactive bladder, diabetes, or a number of other concerns
  • Suggestions are provided on how much water to consume daily; the common “eight glasses per day” recommendation is overgeneralized, and you should instead pay attention to your body’s own individual cues
 

What You Can Learn About Your Health by Analyzing the Color and Smell of Your Urine

May 30, 2013 | 982,785 views
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By Dr. Mercola

Urine can reveal important information about your body’s waste elimination process, providing clues about your overall health status.

Your kidneys serve to filter excess water and water-soluble wastes out of your blood, getting rid of toxins and things that would otherwise build up and cause you to become ill. Many things — from excess protein and sugar to bacteria and yeast — may make their way into your urine.

Instead of ignoring your urine and dashing back to whatever important activity having to pee interrupted, take this golden opportunity to become familiar with your “normal.”

If you notice changes in the way your urine looks or smells, the cause might be something as benign as what you had for dinner last night, such as beets or asparagus. Or, your astuteness may potentially alert you to a serious condition.

If you suspect you have a urinary tract problem, you should consult your physician. One of the first things he or she is likely to do is a urine test. Urine tests have been around for more than 6,000 years1 and are easy, noninvasive tools for quickly assessing your health status2.

Minding Your Pees and Cues

In your lifetime, your kidneys filter more than one million gallons of water, enough to fill a small lake. Amazingly, one kidney can handle the task perfectly well. In fact, if you lose a kidney, your remaining kidney can increase in size by 50 percent within two months, to take over the job of both.3

Urine is 95 percent water and five percent urea, uric acid, minerals, salts, enzymes, and various substances that would cause problems if allowed to accumulate in your body4. Normal urine is clear and has a straw yellow color, caused by a bile pigment called urobilin.

As with your stool, your urine changes color depending on what foods you eat, what medications and supplements you take, how much water you drink, how active you are, and the time of the day.

But some diseases can also change the color and other characteristics of your urine, so it’s important to be alert and informed. With so many variables, you can’t always be sure of what’s causing any particular urine characteristic, short of laboratory testing. However, urine’s character gives you some clues to potential problems that may be developing, giving you time to do something about it.

The following chart outlines some of the most common color variations for urine and their possible origins. The majority of the time, color changes resulting from foods, medications, supplements, or simply dehydration. But there are certain signs that warrant concern.

Color Possible Cause Necessary Action
Yellow/Gold The most typical urine color, indicative of a healthy urinary tract; yellow will intensify depending on hydration; some B vitamins cause bright yellow urine None
Red/Pink Hematuria (fresh blood in the urine) related to urinary tract infection (UTI), kidney stone, or rarely cancer; consumption of red foods such as beets, blueberries, red food dyes, rhubarb; iron supplements; Pepto-Bismol, Maalox, and a variety of other drugs5; classic “port wine” color may indicate porphyria (genetic disorder) ***Consult your physician immediately if you suspect you have blood in your urine
White/Colorless Excessive hydration is most likely. (See Cloudy) Consult your physician only if chronic
Orange Typically a sign of dehydration, showing up earlier than thirst; “holding your bladder” for too long; post-exercise; consuming orange foods (carrots, squash, or food dyes); the drug Pyridium (phenazopyridine); liver or pituitary problem (ADH, or antidiuretic hormone) Drink more water and don’t delay urination; consult physician if orange urine persists despite adequate hydration
Amber More concentrated than orange so severe dehydration related to intense exercise or heat; excess caffeine or salt; hematuria; decreased urine production (oliguria or anuria); metabolic problem; pituitary problem (ADH, or antidiuretic hormone) Consult your physician if problem persists despite adequate hydration
Brown Very dense urine concentration, extreme dehydration; consumption of fava beans; melanuria (too many particles in urine); UTI; kidney stone; kidney tumor or blood clot; Addison’s disease; glycosuria; renal artery stenosis; proteinuria; pituitary problem (ADH, or antidiuretic hormone) Consult your physician if problem persists despite adequate hydration, especially if accompanied by pale stools or yellow skin or eyes
Black RARE: Alkaptonuria, a genetic disorder of phenylalanine and tyrosine metabolism marked by accumulation of homogentisic acid in the blood; poisoning Consult your physician
Green RARE: Unusual UTIs and certain foods (such as asparagus); excessive vitamins Usually benign; consult your physician if it persists, especially if you have pain or burning (dysuria), and/or frequent urination (polyuria), which are symptoms of UTI
Blue RARE: Artificial colors in foods or drugs; bilirubin; medications such as methylene blue; unusual UTIs Usually benign; consult your physician if it persists, especially if you have pain or burning (dysuria), and/or frequent urination (polyuria), which are symptoms of UTI
Cloudy Urinary tract infection, kidney problem, metabolic problem, or chyluria (lymph fluid in the urine), phosphaturia (phosphate crystals), pituitary problem (ADH, or antidiuretic hormone) Consult physician, especially if you have pain or burning (dysuria), and/or frequent urination (polyuria), which are symptoms of UTI
Sediment Proteinuria (protein particles) or albuminuria; UTI; kidney stones; see Cloudy Consult your physician
Foamy Turbulent urine stream; proteinuria (most common causes are diabetes and hypertension) Consult physician if not due to “turbulence”

 

Does Your Urine Smell Like Roses?

If you’re a woman from ancient Rome and your urine smells like roses, you’ve probably been drinking turpentine. This is a high price to pay to woo your suitor with pleasant-smelling pee, as turpentine may kill you! Short of drinking turpentine, there are many common substances that may alter the way your urine smells, which is why it’s helpful to know what’s normal. Urine reflects all of the inner workings of your body and contains a wide variety of compounds and metabolic by-products. Some dogs can actually “smell cancer” in human urine6.

Urine doesn’t typically have a strong smell, but if yours smells pungent (like ammonia), you could have an infection or urinary stones, or you may simply be dehydrated. Dehydration causes your urine to be more concentrated and may have a stronger smell than normal, as do high-protein foods like meat and eggs. Menopause, some sexually transmitted diseases, and certain metabolic disorders may also increase the ammonia smell7. Here are some of the more common reasons your urine’s odor may change:

  • Medications or supplements
  • Certain genetic conditions, such as Maple Syrup Urine Disease, which causes urine to smell sickeningly sweet8
  • Certain foods — most notably asparagus. Asparagus is notorious for causing a foul, eggy or “cabbagy” stench that results from a sulfur compound called methyl mercaptan (also found in garlic and skunk secretions). Only 50 percent of people can smell asparagus pee because they have the required gene. Cutting off the tips of asparagus will reportedly prevent the pungent-smelling pee...but of course, this is the tastiest part!
  • Urinary tract infections
  • Uncontrolled diabetes is known to cause your urine to have a sweet or fruity or, less commonly, a yeasty smell. In the past, doctors diagnosed diabetes by pouring urine into sand to see if it was sweet enough to attract bugs. Other physicians just dipped a finger in and took a taste. Fortunately, today’s physicians have access to far more elegant diagnostic tools.

When You Feel the Urge to Go, GO

Urinary frequency is also important. Peeing six to eight times per day is “average.” You might go more or less often than that, depending on how much water you drink and how active you are. Increased frequency can be caused by an overactive bladder (involuntary contractions), caffeine, a urinary tract infection (UTI), interstitial cystitis, benign prostate enlargement, diabetes, or one of a handful of neurological diseases.9

It is important to pee when you feel the urge. Delaying urination can cause bladder overdistension — like overstretching a Slinky such that it can’t bounce back. You may habitually postpone urination if you find bathroom breaks inconvenient at work, or if you have Paruresis (also known as Shy Bladder Syndrome, Bashful Bladder, Tinkle Terror, or Pee Anxiety), the fear of urinating in the presence of others. Seven percent of the public suffers from this condition.10

How Much Water Should You Drink?

I don’t subscribe to the commonly quoted rule of drinking six to eight glasses of water every day. Your body is capable of telling you what it needs and when it needs it. Once your body has lost one to two percent of its total water, your thirst mechanism kicks in to let you know it’s time to drink — so thirst should be your guide. Or course, if you are outside on a hot, dry day or exercising vigorously, you’ll require more water than usual — but even then, drinking when you feel thirsty will allow you to remain hydrated.

As you age, your thirst mechanism tends to work less efficiently. Therefore, older adults will want to be sure to drink water regularly, in sufficient quantity to maintain pale yellow urine. As long as you aren’t taking riboflavin (vitamin B2, found in most multivitamins), which turns urine bright “fluorescent” yellow, then your urine should be quite pale. If you have kidney or bladder stones or a urinary tract infection, increase your water intake accordingly.

You and Your Urinary System

You should now have a pretty good idea of how important it is to familiarize yourself with what’s normal for your pee. Urine is a window into the inner workings of your body and can function as an “early warning system” for detecting health problems.

The most important factor in the overall health of your urinary tract is drinking plenty of pure, fresh water every day. Inadequate hydration is the number one risk factor for kidney stones, as well as being important for preventing UTIs. To avoid overly frequent bathroom breaks, stay hydrated but not overhydrated. Drink whenever you're thirsty, but don't feel you have to drink eight glasses of water per day, every day. If you're getting up during the night to pee, stop drinking three to four hours before bedtime.

Limit your caffeine and alcohol intake, which can irritate the lining of your bladder. Make sure your diet has plenty of magnesium, and avoid sugar (including fructose and soda) and non-fermented soy products due to their oxalate content. Finally, don't hold it. As soon as you feel the urge to go, go! Delaying urination is detrimental to the health of your bladder due to overdistension.

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