I realize that it may seem strange to be reading a posting about urine. However, last week I wrote about urinary tract infections (which we know are common both in women and in people who have diabetes), so I think this week’s topic is relevant. Also, the color, smell, and consistency of your urine can give you and your doctor helpful information about what might be going on in your body.
Historically, looking at urine has been a way for doctors to gauge a person’s health, especially before other types of testing were available. If you’ve had diabetes for a long time or know someone who has, you’ll know that urine testing was a way to figure out how well controlled (or uncontrolled) a persons’ diabetes was — this was done in the days before blood glucose meters were available. Now, of course, we have more sophisticated tools to convey glucose information. But urine still has its place.
What is urine?
Urine is a waste product that contains breakdown products from food, drinks, medicines, cosmetics, environmental contaminants, and by-products from metabolism and bacteria. Amazingly, urine contains more than 3,000 compounds — much more than what’s found in other body fluids, like saliva or cerebrospinal fluid. The kidneys do a remarkable job of filtering and concentrating to help get these compounds out of the body (you can understand why keeping your kidneys healthy is so important). So, what is your urine telling you?
If your urine is…
Bright yellow. This may look alarming, especially when your urine seems to be glowing in the dark. But don’t worry — the bright yellow color is likely due to vitamins, specifically, B vitamins and beta carotene.
Green or blue. Green or blue urine seems like something straight out of a science fiction movie, but the color is very likely due to certain medicines that you’re taking, such as amitriptyline, indomethacin (brand name Indocin), or propofol (Diprivan). Your urine might also be green or blue due to food dyes or, possibly, a urinary tract infection (UTI).
Orange. Certain medications, like rifampin, sulfasalazine (Azulfidine), and phenazopyridine (Pyridium, used to treat UTIs), laxatives, and some chemotherapy drugs can turn your urine orange. Orange urine may also be a sign of liver problems or dehydration.
Brown. Brown or tea-colored urine can result from antimalarial drugs, certain antibiotics, and laxatives that contain senna or cascara. Fava beans, rhubarb, and aloe can also darken your urine, as can some kidney and liver disorders, such as hepatitis and cirrhosis.
Red or pink. Red or pink urine can be a sign of something serious…or not. Red urine may be due to the presence of blood, and that’s always somewhat concerning. Blood in the urine may be a sign of a UTI, enlarged prostate, a tumor, kidney or bladder stones, menstruation, or injury to the urinary tract. It can also occur if you take blood-thinning medicine or aspirin. Less alarming causes of red urine are beets, berries, and rhubarb.
Cloudy. Cloudy urine can result from a UTI, vaginal infection, or dehydration. If the urine is more milky in appearance, that may be due to the presence of bacteria, mucus, fat, or red or white blood cells.
By the way, “healthy” urine should be pale yellow or straw-colored in appearance.
If your urine smells…
Funny. It’s most likely due to something that you ate. Urine usually doesn’t have a strong odor. But certain foods, such as asparagus, can give it a strong smell thanks to sulfur compounds. Medicines can impart an odor, too. An ammonia-type of smell may be a sign that you’re dehydrated. And a bacterial infection can give your urine a foul odor. Less common causes of funny-smelling urine are rare genetic conditions.
Sweet. Sweet-smelling urine typically indicates the presence of sugar or glucose. Of course, having diabetes increases the chances of spilling glucose into the urine if blood glucose levels are too high. The kidneys will make their best effort to get rid of excess glucose once blood glucose levels climb above 180 mg/dl. In people with Type 1 diabetes and some people with Type 2 who take insulin, sweet or fruity-smelling urine may be due to ketones. Ketones are formed when the body burns fat for fuel, and this can occur when there isn’t enough insulin to move glucose into cells for energy. Urine ketones can be measured using ketone sticks that are available in your pharmacy.
What to do
Urine can look and smell funny for a number of reasons. Most of them are relatively harmless, but if you notice any new changes in your urine or are worried about the appearance or smell, the best thing to do is call your doctor. Also, keep in mind that you may be more likely to have changes in your urine if you:
• Are older
• Are female
• Have a family history of kidney stones or kidney disease
• Do strenuous exercise
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