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Why Does My Urine Smell Strong?

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Why Does My Urine Smell Strong?

From sweet smelling pee that shrieks of uncontrolled diabetes to urine that smells strongly of ammonia due to urinary stones or musty due to liver trouble, the reasons for the change in the smell of your urine are numerous. At times, an unusual urine odor may also stem from underlying medical causes such as dehydration, UTIs, or maple syrup urine disease.

You probably don’t give too much thought to your pee and what it looks and smells like. But if you’ve noticed a sudden change in the smell of that urine, you may want to know what’s causing it. Sometimes, it could be due to a health problem that may need the attention of a doctor, so don’t put off investigating this further. What follows are some symptoms to watch out for and the most common causes of smelly urine. However, there may be times that medication or certain health conditions unique to you are bringing on the problem. And that’s why it is critical that you let your doctor know if you spot anything amiss.

Why Do You Have Strong Or Unusual Smelling Urine?

Urine that is normal and healthy shouldn’t have a strong smell. However, sometimes you may find it does have a strong odor or that it smells of ammonia. Sometimes, it could even smell very sweet. All of these could be symptoms of an underlying medical condition that needs treating.1

1. Urinary Stones

Urinary stones may result in urine that smells like ammonia. Kidney stones as well as bladder stones can both result in an ammonia-like odor.2

Bladder stones may occur as a result of concentrated urine forming crystals and usually occur only in men. The urine is also very dark and may sometimes be accompanied by some blood.3 Kidney stones can result in a constant need to pee, ability to only urinate a little at a time, pain while urinating, and possibly even blood in the urine.4

2. Urinary Tract Infection/Bladder Infection

Urinary tract infections (UTIs) and bladder infections sometimes warrant urgent medical attention so you should be alert to symptoms. Besides foul smelling urine, other signs of a UTI are that you may feel the need to urinate more often, have sudden urges to pee, feel like the bladder isn’t fully empty even after you have peed, have a pain in your lower abdomen, and generally experience aches and tiredness. If you have back pain, fever, chills, or a burning pain when you pee, you should rush to your doctor at the earliest.5

3. Cystitis

An inflamed bladder could also cause your urine to smell in this particular kind of UTI in women. Those with the problem complain of fishy smelling urine or strong smelling pee. You may also experience pain or stinging sensations when you pee. A greater urgency to pee as well as a need to go more often are other signs. You may also feel like you’re unwell, all tired and achy. The urine itself may also be dark and cloudy.6

4. Dehydration

Your urine contains waste products that need to be expelled from the body along with water. When you drink less water, the waste matter becomes more concentrated and can cause urine to smell stronger than usual. This darker, more concentrated urine can appear early in the morning when you haven’t drunk much water over the night or when you’ve not had enough water and the body is dehydrated.7

5. Diabetic Ketoacidosis

In those with diabetic ketoacidosis, the body uses fat to fuel the body instead of sugar or glucose. As a result, ketones or blood acids build up in the system resulting in urine that smells subtly different, accompanied by fruity breath.8

6. Type 2 Diabetes

When you’re unable to keep your diabetes in check as a patient of Type 2 diabetes, you could end up with sweet smelling urine. This is due to glucose or sugar from your body spilling into the urine because their levels are too high in your system.9 Other signs that your problem may be diabetes-linked are feeling very thirsty, needing to pee more often (especially at night), tiredness, weight loss, slow healing wounds, blurred vision, and reoccurrence of thrush.10

7. Gastrointestinal Bladder Fistula

Some people have an abnormal connection between the intestines and their bladder. This can cause problematic urinary tract infections as well as smelly urine. Another sign to watch for is if gas or even stool-like substances appear to emerge from the urethra while urinating.11

8. Maple Syrup Urine Disease

A rare genetic condition, maple syrup urine disease causes problems with breaking down some amino acids in the proteins you consume. The result is your pee smells like maple syrup as the chemical buildup from undigested leucine, isoleucine, and valine changes how your urine smells. Due to the risk of brain damage in instances of fever, infection, or other physical stress, timely diagnosis is important. Lethargy, seizures, vomiting, and feeding difficulties are warning signs. It could even cause a person to go into a coma.12

9. Phenylketonuria

Another cause for musty smelling urine is phenylketonuria or PKU. This is a genetic condition that causes the buildup of phenylalanine, an amino acid that cannot be processed, in the blood and even your brain. As this buildup continues unchecked, it could cause brain damage and must, therefore, be treated as soon as possible. Behavioral problems like tantrums, having fairer eyes, hair, and skin than siblings who don’t have the problem, vomiting, eczema, epilepsy, tremors and musty smelling breath are other signs of this ailment.13

10. Liver Disease

Liver trouble can also result in urine that is musty smelling.14 Because your liver needs to break down urea in the body, if it malfunctions it causes excess buildup of ammonia. The ammonia passes out through your urine, causing that trademark foul smelling pee.15

11. Food And Supplements

Certain foods or supplements too may cause urine to smell. For instance, asparagus is a known offender that doesn’t just cause urine to take on a greenish tinge, but also causes pee to smell bad. Other strong smelling foods like garlic or beer and even coffee too may have this effect.16 Besides such foods, Vitamin B6 supplements too can cause urine to smell funny as the body expels any excess via the urine.17

References   [ + ]

1, 2, 7, 16. Smelly urine. National Health Service.
3. Bladder stones.U.S. National Library of Medicine.
4. Symptoms & Causes of Kidney Stones.The National Institute of Diabetes and Digestive and Kidney Diseases.
5. Urinary tract infections in adults. National Health Service.
6. Cystitis – Symptoms. National Health Service.
8. Diabetic ketoacidosis. U.S. National Library of Medicine.
9. Adeghate, E. “Diabetes mellitus–multifactorial in aetiology and global in prevalence.” Archives of physiology and biochemistry 109, no. 3 (2001): 197-199.
10. Type 2 diabetes – Symptoms. National Health Service.
11. Bladder Fistula. Urology Care Foundation.
12. Maple syrup urine disease. U.S. National Library of Medicine.
13. Phenylketonuria. National Health Service.
14. Urine odor. U.S. National Library of Medicine.
15. Ammonia.University of Rochester Medical Center.
17. .Office of Dietary Supplements.