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What Causes Dark Urine And How To Treat It

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What Causes Dark Urine And How To Treat It

Simple things like dehydration or something you ate (fava beans, beets, blackberries, rhubarb) can give your urine a darker color. So can urinary tract infections, liver diseases, gallstones, kidney stones, an enlarged prostate gland, and cancer. So if your urine's dark and you’ve ruled out the obvious things like dehydration and certain foods then it might be a good idea to visit a doctor.

Does your urine seem darker in color than usual? Are you wondering if you should be worried? Your urine is made up of extra water and waste products filtered out by your kidneys. Normally, it can range in color from a pale yellow to amber depending on the concentration of waste products in it, which is usually dependent on how much fluids you consume. A variety of things can turn your urine a darker shade. While some of them can be pretty harmless, a darker shade of urine could also indicate a serious medical concern.1

Here’s a look at some of the conditions that could turn your urine dark:

Why Is My Urine Dark?

1. Dehydration

Dehydration happens when the body lacks sufficient fluids. When the water content in your body is low, the natural balance of minerals in your body is also upset and this can cause major problems. Along with dark urine and a dry mouth, feeling lightheaded, tired, and thirsty are all early signs that you might be dehydrated.

You can get dehydrated when you exercise for long periods (and lose water through sweat) or due to illnesses like vomiting and diarrhea.

What To Do Next: Drinking fluids like water and fruit juice can help when you’re dehydrated. Sip small amounts at regular intervals if you feel like throwing up. Try a salty snack to replace lost salt.2

Severe dehydration can be life threatening and should be considered a medical emergency. If you haven’t urinated in eight hours, or you feel confused, tired, and dizzy when you stand up you might be severely dehydrated. Having a weak or rapid pulse, and fits are other signs that indicate this. Please get immediate medical attention if this is the case.3

Small children shouldn’t be given only water when they’re dehydrated as it can dilute minerals levels and cause problems. Try an oral rehydration solution which is available over the counter – your doctor will be able to recommend one for you. This solution contains sodium and potassium salts as well as starch or glucose.4

2. Foods You Ate

Some foods can change the color of your urine when you have them. For instance, blackberries, rhubarb, and beets can turn it red or pink. Rhubarb, aloe, and fava beans can give it a dark brown or tea color while carrots and vitamin C can turn it orange. If your urine is green, it could be due to all that asparagus you ate.

What To Do Next: If you’ve been eating food that can change the color of your urine, stop eating that particular food and see if your urine returns to its normal color. Color changes in urine due to food are temporary and harmless.5

3. Medications

Certain medications such as some antibiotics or laxatives can also turn your urine red or brown.6 Supplements like B vitamins can also give urine a fluorescent yellow-green color.

What To Do Next: Speak with your doctor to find out if any medication that you’re on could be responsible for changing the color of your urine. If the change is due to medication, it should not be a cause for worry.

4. Liver Diseases

Bilirubin is a yellow waste product which is made when old or damaged red blood cells break down. This gives urine its pale yellow color and stool its darker brownish color. Bilirubin is usually transported to the liver where it combines with bile. Some liver diseases can affect the liver’s capacity to process bilirubin due to which more bilirubin can be excreted through urine, giving it a darker color.

Here are some liver diseases that can cause dark urine:

Hepatitis is inflammation of the liver. It is usually caused by viruses and can take the form of hepatitis A, hepatitis B, and hepatitis C. Symptoms can include a fever, poor appetite, vomiting, and pain in the abdomen. Generally, urine turns dark after 3 to 10 days.

What To Do Next: Sometimes, hepatitis goes away on its own. It can also be treated with antiviral medications. Vaccinations are available for hepatitis A and hepatitis B. However, some cases may even require a liver transplant.7

Primary biliary cholangitis or primary biliary cirrhosis is a disease where your immune system mistakenly attacks your bile ducts. This leads to bile building up in the liver which then damages it.
This condition may not cause symptoms initially. You may also feel fatigued or have a dry mouth and eyes, itchy skin, pain in the abdomen. You may have trouble sleeping at night or feel dizzy when standing up. As the disease advances, it can cause dark urine and pale stools.

What To Do Next: Your doctor may advise medication to treat symptoms like dry eyes or itchy skin. In severe cases, a liver transplant may be recommended.8

Cirrhosis is scarring of the liver and impaired liver function. It is usually seen as the last stage in chronic liver disease. It can be caused by various factors like alcohol abuse or bile duct disorders. Accumulation of fat in the liver not caused by alcohol abuse can lead to conditions known as nonalcoholic fatty liver disease and nonalcoholic steatohepatitis may be related to being overweight or having hepatitis. Some other symptoms of cirrhosis may include fatigue, loss of appetite and weight, and nausea. As the condition worsens you may experience fluid buildup in the legs and abdomen, redness in the palms, yellowing of skin or eyes etc.

What To Do Next: Your doctor may give you medication to treat symptoms like fluid buildup. As the condition progresses, you may need a liver transplant.9

Following certain guidelines like staying at a healthy weight, limiting how much alcohol you drink, and stopping smoking can generally help with the health of your liver.10

5. Gallstones

Gallstones can cause dark urine. They’re usually made of cholesterol or bilirubin and may not cause any symptoms or need treatment. But sometimes a gallstone can block a duct in the gallbladder or cause inflammation of the gallbladder. You may experience severe abdominal pain if this happens.

What To Do Next: Having a healthy balanced diet and avoiding foods high in saturated fats can be helpful. Your doctor may also recommend surgery to remove your gallbladder if you have severe symptoms. Don’t worry, you can have a normal life without a gallbladder as it isn’t an essential organ.11

6. Cancer

Cancers of the pancreas, gallbladder, and bile duct can cause the buildup of bilirubin, which in turn leads to dark urine.

What To Do Next: The first course of action will be tests prescribed by your doctor to establish if you have cancer. Your doctor may then advise chemotherapy or radiotherapy to treat it.12

7. Blood In The Urine

The presence of blood in your urine can turn it a darker shade. Some common disorders that may cause blood in your urine include:

Kidney infection or kidney stones. Kidney infections may also mean a high temperature and pain in the side of your abdomen while kidney stones can be painless or may cause abdominal pain.

Enlarged prostate gland, which is commonly seen in older men. If you have this condition you may have trouble urinating or may need to urinate frequently.

Bladder infections, which usually also cause pain when you urinate.

Urethritis, which is an inflammation of the urethra (the tube which moves urine out of the body). Sexually transmitted diseases like chlamydia, injuries, sensitivity to certain spermicides etc. can cause this condition.13

Cancers of the bladder, kidney, and prostate can lead to blood in your urine. While bladder cancer can also cause frequent urination as well as pain while urinating, kidney cancer can trigger a constant pain below the ribs as well as a lump in the stomach. Prostate cancer may make it difficult for you to urinate and yet cause a frequent need to urinate.

What To Do Next: If you notice blood in your urine or think that your urine has turned dark because of blood, it is important to see a doctor and figure out what’s causing it. While some conditions like urinary tract infections (infections of the kidney, bladder, or tubes connecting them) may be treated with antibiotics, something like cancer may require chemotherapy or radiotherapy.14

8. Black Urine Disease

Black urine disease or alkaptonuria is a rare hereditary disease where you can’t break down tyrosine and phenylalanine, which are protein building blocks, completely. This results in the buildup of homogentisic acid in the body. This can turn urine and sweat black and give you black spotted skin and bluish nails.

One of the early signs in affected babies is dark stains in their nappies. This is because urine with homogentisic acid turns black when exposed to air for a few hours. If this is missed, a person may not show other symptoms till their late twenties or early thirties. Homogentisic acid will, however, slowly build up in tissues. As it builds up, it can cause a range of issues like pain, loss of joint movement, heart disease, and breathing problems.

What To Do Next: Alkaptonuria is a chronic condition without a cure but reducing protein in the diet can slow its progression. Gentle exercise can help to build muscles and strengthen joints.15

References   [ + ]

1. Urine color and odor changes. Harvard Health Publications.
2, 4. Dehydration. National Health Service.
3. Dehydration – Symptoms. National Health Service.
5. Urine color and odor changes. Harvard Health Publications.
6, 14. Blood in urine (haematuria). National Health Service.
7. Beers, Mark H., Andrew J. Fletcher, T. V. Jones, R. Porter, M. Berkwitz, and J. L. Kaplan. The Merck manual of medical information. Pocket Books, 2003.
8. Primary biliary cirrhosis (primary biliary cholangitis). National Health Service.
9. Cirrhosis. National Institutes of Health.
10. Primary biliary cirrhosis – Treatment. National Health Service.
11. Gallstones – Treatment. National Health Service.
12. Signs and symptoms of bile duct cancer. American Cancer Society.
13. Urethritis. National Institutes of Health.
15. Alkaptonuria. National Health Service.