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URINE COLOR CHANGE

Changes in the appearance of urine can happen for different reasons. They are typically seen as changes in the color, smell or the consistency of a person's urine. These changes are often harmless and can be caused by diet or medications. However, urine changes can also be caused by conditions like urinary tract infections, liver failure and kidney stones.

Normal urine should be clear and free of clouds or particles and pale yellow in color. Occasionally, urine can turn a bright yellow color. Urine can adopt a wide range of colors, and each has a different meaning for health status. Often, dehydration causes bright yellow urine.

Some foods, vitamins, and medications a person uses may have an impact on the way urine looks and smells.

Balanced urine gets its yellow color from urochrome, a waste product that comes from the breakdown of hemoglobin. Hemoglobin is the protein in red blood cells that enables oxygen to travel around the body.

Red blood cells are renewed every day in their millions, so the body needs to break down old cells. The urochrome from this process ends up in the urine as the yellow color.

Darker shades of yellow suggest that the individual may be dehydrated and needs water.

While bright yellow urine does not necessarily indicate dangerous health issues, it is important to keep a close eye on the color of urine.

COLORS

Urine can turn a range of colors, and some highlight medical problems.

There may be other causes of color changes in the urine. People should talk to their doctors about any concerns about unusual urine color. Listed below are many of the colors and their possible causes.

Orange urine

Certain drugs and medications can lead to orange urine. (E.g. the antibiotic rifampicin and the pain-reliever phenazopyridine). Some laxatives and chemotherapy drugs can also color the urine orange.

Some dietary factors behind orange urine include a high intake of carrots. A substance called carotene that these vegetables contain can impact urine color. Vitamin C, blackberries, beetroot can also have this effect.

Red urine

Red coloring in the urine has a number of causes. Blood in the urine, known as hematuria, is a possible cause of red urine. People should see their doctor about red urine, as hematuria can be serious.

Hemoglobinuria, a blood condition, can also cause red urine, as can myoglobinuria, which has to do with a waste product of the breakdown of muscles.

Brown urine

Medicines that turn urine brown includes:

  • Antibiotics, such as metronidazole (Flagyl)
  • Sennoside laxatives, such as Senna-Lax
  • Antipsychotic drugs, such as Thorazine and Mellaril
  • Phenytoin or Dilantin (an epilepsy drug)

Deep purple urine

A condition called porphyria causes urine to appear deep purple.

Porphyria is a rare metabolic disorder.

Green urine

The urine can turn green because of the following:

  • Dyes used in kidney tests, including indigo-blue, indigo carmine, carbolic acid
  • Infection with Pseudomonas bacteria
  • Drugs and other compounds containing phenol, such as promethazine, used for allergy and nausea.
  • The antidepressant amitriptyline, cimetidine, which reduces stomach acid, and the painkiller indomethacin
  • Biliverdin, a bile pigment
  • Methylene blue, this is a dye that has also been used as a drug

OTHER URINE CHANGES

Urine through its smell, clarity, and translucency as well as color, can indicate changes in the body.

Cloudy urine

Cloudy urine can signal a number of possible problems. For women, it could be a result of vaginal discharge.

Other changes that may cause cloudiness include:

  • Urinary bladder infections and lower urinary tract infections (UTIs)
  • Infection can also cause white or milky-looking urine.
  • Dehydration
  • Kidney disease, including kidney stones
  • Kidney problems and excess protein can also make the urine foamy.
  • Temporary foaminess is usually a result of an unsteady urine flow.

Urine odor

The smell of urine can also change. Some changes are harmless, while others are a sign of disease:

  • Urine that smells sweet could be a sign of diabetes.
  • Eating a lot of asparagus can make the urine smell like rotten cabbage.
  • UTIs can cause the urine to have a foul smell.

CAUSES OF DARK URINE

Urine consists of excess water and waste products that the kidneys filter from the blood. It can range from pale yellow to dark amber depending on the ratio of water to waste products.

Many things can affect the color of urine. Most of these are harmless, but a change in color can sometimes signal a health problem.

Dehydration

Dark urine is usually a sign of dehydration. Dehydration happens when there is not enough water in the body.

Aside the dark urine, it causes:

  • Dizziness or weakness
  • Fatigue
  • Dry mouth and lips
  • Thirst
  • Trouble swallowing dry food
  • Constipation

Older adults, children, and people living with severe illnesses (e.g. cancer), are more prone to dehydration.

In most cases dehydration can be treated by drinking more clear fluids, such as water and herbal tea.

People should seek medical advice in case they have any, some, or all of the under listed symptoms:

  • Lethargy - State of tiredness, weariness, fatigue, or lack of energy.
  • Very dry mouth and tongue - A dry mouth is a normal sign of dehydration or feeling nervous but a persistently dry mouth can be a sign of an underlying problem.
  • Skin that moves back very slowly after being pinched - Mild dehydration will cause the skin to be slightly slow in its return to normal.
  • Weak or absent pulse - A weak Pulse. A weak pulse may indicate low blood pressure, heart disease or a blood vessel blockage
  • Very low blood pressure - When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs
  • Minimal or no urine - Causes include, Dehydration from not drinking enough fluids and having vomiting, diarrhea, or fever or even total urinary tract blockage.

Food, drink, or medication

  • Some foods and drinks can also cause a change in the color or smell of urine. For instance beets and blackberries can turn the urine red and eating rhubarb can result in a dark brown or tea-like color.
  • Some medications can also cause changes in urine color: Senna, chlorpromazine, and thioridazine can result in red urine.
  • Rifampin, warfarin, and phenazopyridine can result in orange urine.
  • Amitriptyline, indomethacin, cimetidine, and promethazine can result in blue or green urine.
  • Chloroquine, primaquine, metronidazole, and Nitrofurantoin can result in dark brown or tea-colored urine.

Hemolytic anemia

Hemolytic anemia can cause fatigue and headaches. Red blood cells develop in the bone marrow. The body normally destroys old or faulty red blood cells in the spleen in a process called hemolysis. When the body turns on itself and destroys too many red blood cells, a person might develop hemolytic anemia.

Genetic blood disorders, such as sickle cell disease or thalassemia, can also lead to hemolytic anemia.

In addition to dark urine, symptoms of hemolytic anemia include:

  • Dizziness
  • Heart palpitations
  • Fatigue
  • An enlarged spleen or liver
  • Pale skin
  • Headaches
  • Jaundice, or yellowing skin and eyes

In severe cases, hemolytic anemia can lead to:

  • Fever
  • Shocks
  • Chills
  • Back and abdominal pain

Urinary tract infections

Urinary tract infections (UTIs) happen when bacteria gets into the bladder, usually through the urethra. Women tend to develop UTIs more often than men, and many people know them as cystitis or generally as bladder infections.

Symptoms of UTI include:

  • pain or burning while urinating
  • pain or pressure in the abdomen
  • frequent urges to urinate
  • urine that is cloudy, dark, or appears bloody

Hepatitis C

The hepatitis C virus (HCV) can cause an infection of the liver. This infection normally has few symptoms during the early stages, so many people would not be aware they have it until liver damage starts causing problems because it affects how the liver processes waste, HCV causes dark urine.

Risk factors include sharing needles, having sex without a condom with a person who has HCV, and receiving tattoos using unsterile equipment.

When they occur, symptoms usually appear within 2 weeks to 6 months of exposure to the virus. They are generally mild and may include:

  • Dark urine
  • Sore muscles
  • Fatigue
  • Joint pain
  • Fever
  • Stomach pain
  • Itchy skin
  • Nausea or poor appetite
  • Jaundice

SYMPTOMS OF CHANGES IN URINE

The symptoms of changes in urine are very easy to see or smell. They typically include:

  • Strong odor
  • Change in urine color
  • Foaming of urine

WHEN TO SEE A DOCTOR

Often times, cases of urine color change do not need medical attention. Many of the urine color changes are temporary or reversible with a change in diet or medication. Most of the changes are harmless.

People must seek medical help whenever dehydration is caused by illness, or if the person is unable to take in fluids. Dehydration can be dangerous for anyone, but especially young children or older adults.

A clear indicator for the need to see a doctor is red-colored urine. If there is any doubt about the cause of a change in the urine, people should see a doctor.

Certain conditions that change urine color rarely occurs but are serious. Tumors in the urinary tract for example is a rare cause but which will need urgent diagnosis.

RISK FACTORS

Age and gender may raise one's risk for conditions that can affect urine color. Tumors in the kidney or bladder for example, are common in older adults. Bleeding in the urinary tract is commonly associated with problems of the kidney or bladder.

Conditions such as cancer which are more serious, can also cause bleeding and pink or red urine. People should inform their doctors right away if they notice blood in their urine so that the causes can be determined.

A very significant 60 percent of all women experience a UTI at least once in their lives. These infections may be accompanied by urinary tract bleeding, which can change the color of urine. Some men may also experience urinary blood as a result of an enlarged prostate gland.

Bleeding in the urinary tract is much less common among children, except that certain rare disorders may cause blood in the urine. These may include Hemolytic uremic syndrome, and Wilms' tumor.

Just like in adults, any urinary tract bleeding in children is considered abnormal and should prompt immediate medical attention.

DIAGNOSIS

The doctor will perform physical exams which may include a rectal or pelvic exam. He will ask questions about symptoms such as the following:

  • Could there be a family history of kidney or bladder cancers?
  • Whether they have any other symptoms (such as pain, fever, or increase in thirst)?
  • When the change in color of the urine was first noticed and how long has the problem been?
  • What color is the urine and does the color change during the day? Is there blood in the urine?
  • Have they noticed anything that makes the problem worse?
  • What types of foods the individual has been eating and what medicines do they take?
  • Whether they have a history of urinary or kidney problems?
  • If they smoke or are exposed to significant second hand tobacco?
  • Whether they work with chemicals such as dyes?

Tests that may be done may include:

  • Urinalysis
  • Urine cytology
  • Blood tests, including liver function tests
  • Ultrasound of kidneys and bladder or CT scan
  • Urine culture for infection
  • Cystoscopy

TREATMENT

People who may be experiencing severe dehydration will need rehydration therapy. This therapy involves administering oral rehydration salts or fluids and electrolytes in the hospital.

Dark urine due to food, drink, or medications do not raise any cause for concern. The urine normally will return to its normal color once the person stops consuming whatever is causing the change.

Many cases of hemolytic anemia do not require treatment. Lifestyle changes can help control symptoms for others causes. In severe cases of hemolytic anemia, blood transfusions, blood and bone marrow transplants, or surgery to remove the spleen may be necessary.

For UTIs, doctors will usually prescribe a short course of antibiotics. People with severe infection may require a longer course of antibiotics. Some people may complement the treatment regimen with pain relievers.

OUTLOOK

If urine takes on a dark-yellow color, it may be the body's way of telling one to drink more water. This change in color may be caused by dehydration, so drink up.

If an individual is taking any medication that causes this discoloration, it is likely to be harmless. People should continue taking their medications under the supervision of their doctors, unless otherwise advised.

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