What Your Urine Color Might Be Saying About Your Health
Do you notice the color of your pee? If so, you're actually following an ancient medical tradition. In ayurvedic practice, the science of decoding the color of urine and a patient's state of health goes back to about 100 BCE and accounted for about 20 different colors. Medieval medicine considered bright yellow—due to the pigment urochrome—to be the best indicator of overall well-being.
Although your body loses fluids simply by sweating and breathing, urination is far and away the main channel. It's not surprising that we take time to notice it. And if you do, here are a few things to remember:
Clear urine is an indicator that you're hydrated—but it's not always a good thing.
Clear urine can be a sign that you're hydrating well and that your body is putting water-soluble nutrients to good use. If water is your go-to drink during the day, this is pretty common.
However, clear urine isn't always a sign of good hydration. If you are going a lot and it's clear, it could be a sign of a condition called diabetes insipidus. In these cases, an individual may pass three to 20 (!) quarts of urine through the kidneys each day. Even though this condition may sound like "diabetes"—and type 1 and type 2 diabetes can cause frequent urination and thirst—it is actually an unrelated and rare condition. People with diabetes insipidus have normal blood sugar levels, but their kidneys simply cannot process fluids properly. If you are concerned with how often you need to go, consider checking things out with your doctor.
Cloudy or milky urine could mean a number of different things.
Cloudy or milky urine can be caused by all kinds of things, so if you notice it in the morning, or only occasionally, don't panic. It could indicate a uric acid excretion, urinary tract infection, or a release of some lipids (fats) through your system. An occasional milky or cloudy appearance of urine can be normal—especially in the morning when you may be slightly dehydrated.
There is some controversy1 over whether or not cloudy, foul-smelling urine is actually a sign of urinary tract infection. Foods and medications can also be the cause, so frequent testing (especially for older adults) probably isn't necessary. In fact, some professionals feel that simply going by appearance and smell alone could actually lead to overprescription of antibiotics and cause greater resistance to bacteria like Clostridium difficile, better known as C. diff. This source of infection is extremely difficult to treat and potentially deadly following surgery. Just three years ago, the Centers for Disease Control and Prevention2 (CDC) reported that this one bacteria caused 500,000 cases of infection in one year—and about 15,000 deaths. So there's a good reason not to read too much into any one-off circumstance.
But the fact is, consistently cloudy urine can mean that you do have some type of bacterial infection (pyuria) and that you are seeing pus in your urine and elevated white cell activity as your body tries to fight it.
Other conditions associated with cloudy urine can be a neurogenic (also called a neuropathic) bladder caused by spinal injury or some other serious damage. If you notice cloudiness that seems timed to having been in a car accident, for example, definitely get it checked out.
As for high uric acid levels, this is a situation that can lead to gout—an extremely painful joint condition. However, cherry consumption, in supplemental form to avoid sugars, can help. And simply drinking eight, 8-ounce glasses of water dilutes uric acid and can cut instances of gout attacks in half.
The bottom line is, if your urine suddenly appears cloudy or you notice it happening often, talk to your health care practitioner to rule out anything serious.
Colored urine can point to something more serious.
Fun fact: Pink, red, or brown (tea-colored) urine was, in the past, sometimes associated with a personality type known as "choleric." That doesn't mean that they had cholera; it simply described an individual who was a "go-getter" and goal-oriented (and maybe a bit abrasive). But in more modern times, this color range could indicate hematuria: blood in the urine. According to the National Institute of Diabetes and Digestive and Kidney Disorders, a division of the National Institutes of Health, hematuria could have many causes, including an enlarged prostate or urinary tract infection. You could also be exercising strenuously, which can lead to some internal bleeding.
Men often experience some prostate issues as they age, and that's perfectly normal. Prostate enlargement is the most common prostate concern for men from ages 45 to 74, and half of all men in their 50s have some symptoms. And by the age of 80, up to 80 percent of men are dealing with benign prostate enlargement (BPH).
Bear in mind that sometimes blood in the urine can't be seen at all and requires specialized testing to detect. In any case, if you see dark urine, talk to your doctor.
Multivitamins can turn your urine a bright yellow or orange, especially water-soluble vitamins B12 and vitamin C. If you've just started taking a new multi- or a B vitamin supplement, be aware that changes to your urine are perfectly natural. Common mouthwashes—especially ones that use green or blue food dyes—can be reflected in the color of your urine as well.
Dark urine? Drink more water.
Dark-yellow urine in the morning may be due to an overnight state of dehydration, alcohol imbibing the previous evening, or an imbalance of pH levels. Dark urine during the day may simply be a case of low-level dehydration or excreting the color of food and drink.
Hydration is key. if your urine is consistently a dark yellow, you may need to boost your water intake during the day. While "eight, 8-ounce glasses of water" is the standby rule, go with what works and how much replenishment you may need. If you're gardening outside all day in the summer, doing intense workouts, or just sweat a lot, drink more water—it's as simple as that.
Pay attention to the frequency of your urine, too.
Finally, if you feel like you need to go more than usual, or that your bladder doesn't quite feel empty each time you do go, you may need a little supplemental bladder strengthener. A proprietary extract of the leaves of an Icelandic herb, Angelica archangelica3, has been clinically shown to help strengthen bladder muscles and capacity. And for those who need to "get up and go" during the night, people supplementing with angelica had more restful, uninterrupted sleep.
In fact, in a subset of men in the study, it tripled the time to first awakening to use the bathroom and reduced the nocturnal awakenings for urination by 50 percent. Additionally, the Angelica archangelica extract was very well-tolerated and showed no hormonal effects or unwanted side effects like increased blood pressure or heart rate or reduced libido.
The color of urine and its clarity or cloudiness is a much richer medical topic than you might have guessed with just a casual glance. But there are many things to consider if you notice cloudiness or an off-color. Remember that diet, supplements, medication, alcohol intake, and myriad variables can be at work here.
Don't be afraid to bring your questions to your doctor. Remember, your doctor has seen and heard everything, so don't hold back when you need to discuss your concerns. If they think it's necessary, they can order up the laboratory tests that can ultimately clear up any of your doubts.
Ajay Goel, Ph.D., is a professor and the director of Translational Genomics and Oncology, as well as the director of the Center for Gastrointestinal Research at the Baylor Scott & White Research Institute at Baylor University Medical Center. Goel is one of the top scientists in the world investigating botanical interventions and has dedicated over 20 years to cancer research.
As a research pioneer, Goel is a member of the American Association for Cancer Research and the American Gastroenterology Association. He is also on the international editorial boards of Gastroenterology, Clinical Cancer Research, Carcinogenesis, PLoS ONE, Digestive Diseases and Sciences, Scientific Reports, Epigenomics, Future Medicine, Alternative Therapies in Health and Medicine, and World Journal of Gastroenterology. Goel further serves on various grant funding committees for the National Institutes of Health (NIH) and several international organizations.
In addition to a thriving career in medicine, Goel is a big supporter of the movement for more simple, natural foods and improved dietary practices. He also works privately with an organization in India to provide food, shelter, education, and care for orphaned children.