Overview
Naturally, the color of urine ranges from pale yellow to deep amber, depending on the amount of water you drink. Pale or transparent yellow urine shows sufficient hydration; clear or transparent urine indicates overhydration; and dark yellow to amber or orange to dark orange urine indicates dehydration. Such changes in urine color are due to a yellow pigment called urochrome or urobilin, which is a breakdown product of the blood’s hemoglobin that gets excreted through the kidney.
The color of urine can also be affected by certain medications, vitamins, pigments, or food types that you take. However, the color of urine can sometimes signal a health problem or disease, including urinary tract infection (UTI), kidney, or bladder cancer. For example, brown urine is a sign of kidney, liver, or bladder disease or injury. But it could also be due to your diet or current medication. That is why urine is usually described as a window into your diet and health.
What causes changes in urine color?
Below are details on factors which contribute to changes in urine color. Changes in urine color may depend on one or many of these factors and in most cases it is completely harmless and will subside. But if such changes persist, then contact a doctor.
Urochrome
Urochrome is the chemical mainly responsible for the yellow color of urine. It is a waste product which results from the breakdown of hemoglobin during red blood cell destruction. Urochome is removed from the body by the kidney. So, the more water you drink, the more it becomes diluted in your urine giving it an almost colorless appearance. However, the lesser water you drink the more urochome becomes concentrated in your urine giving it color ranging from pale yellow to dark amber.
Diet, pigments and Vitamins
Naturally colored foods such as berries, beets and rhubarb contain pigments which can temporarily turn your urine red, pink, or dark brown respectively. This can give a force alarm that there is blood in urine (hematuria). However, eating these foods doesn’t always cause a visible effect since many factors such as the acidity of your stomach, the mixture of what you eat or the time you eat will all play a role. Other food types which can also alter your urine color include fava beans, aloe or carrot. This will give your urine dark brown, tea colored or orange appearance respectively.
Vitamins can also cause a change in urine color. Beta carotene and Vitamin C (or ascorbic acid) gives urine an orange or dark yellow color while B-vitamins such as Vitamin B2 (riboflavin) and Vitamin B12 (Cobalamin) gives urine a fluorescent yellow-green color. Therefore taking multivitamin supplements can make your urine brightly colored and should not be a call for alarm.
Medication
Most drugs or medications change the look of your urine. It is a perfectly normal and harmless situation. The table below shows some common medications which cause urine to change color and the color changes they bring to your urine.
| Medication | Urine Color |
|---|---|
| Nitrofurantoin (Furadantin), chroroquine (Aralen), primaquine, metronidazole (flagyl), furazolidone (Furoxone), Acetaminophen or Tylenol (when taken in overdosed) | Dark brown or tea-colored |
| Ibuprofen, senna (Ex-Lax), Chlorpromazine (Thorazine), thioridazine (Mellaril), phenytoin (Dilantin) | Pink or Red |
| Amitriptyline, indomethacin (Indocin), cimetidine (Tagamet), promethazine (Phenergan), methylene blue (when used as a drug), zaleplon (Sonata), Methocarbamol (Robaxin), Metoclopramide (Reglan) | Blue or green |
| Rifampin (Rifadin), warfarin (Coumadin), phenazopyridine (Pyridium), isoniazid, sulfasalazine | Orange |
Urinary Tract Infection (UTI)
UTIs can turn urine pink, red or cola-colored. This is due to the presence of blood in urine (hematuria). If the amount of blood is small, then it will be visible only under the microscope but large amount of blood flow can be viewed with the naked eyes. UTIs can also cause urine to appear white, milky or cloudy.
Medical Condition
Kidney and bladder stones or cancer can cause blood in urine. Other symptoms associated with this can include pain when urinating, back pain, fever, chills, nausea and vomiting. Kidney diseases such as Polycystic kidney disease (PKD) can also cause blood in urine.
Strenuous Exercise or Injury
Injury to the kidney, bladder or urinary tract will cause blood to leak into urine giving it a pink, red or dark-brown color. Strenuous exercises repeatedly damage the bladder causing blood to also leak into urine.
Other conditions which cause blood in urine include hemolytic anemia in which red blood cells are destroyed, liver disorder such as hepatitis or cirrhosis.
A rare metabolic disorder called porphyria also causes urine to appear deep purple.
Other factors and changes
Women can experience blood in urine during or few days after menstruation.
Kidney disorders, excessive dehydration, mineral or protein intake can also cause cloudy, foamy or white urine.
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Urine colors and their meaning
The figure below shows the different urine colors and their meaning. Apart from urine color changes, the figure also includes other changes such as foamy, smelling or cloudy urine and their meaning. This comprehensive picture tells you exactly what could be wrong with your urine.
Diagnosis
Most changes in urine color are associated with dehydration, medication or diet and will easily go away when you stop taking these. Therefore when you notice a change in urine color it is important to quickly evaluate the following:
- Have you been drinking enough water? Remember that the more water you drink, the clearer and less concentrated your urine. But less water means concentrated urine and this can vary from pale yellow up to amber.
- What did you eat or consumed lately? If it was food, then what was the color and does it have any known side effect? But if it’s a medication or vitamin supplement, then check the color and any possible side effects.
- When did you first notice the change? If it is diet, medication or vitamin related, then it should go away when you stop taking that diet or medicine. Similar if dehydration was responsible, then taking sufficient water should also clear any abnormal color changes.
- Are you menstruating? Women general observe brown, pinkish or red urine during menstruation or immediately after menstruation.
When to see a qualified medical doctor
Book an appointment with a doctor if the following occur or accompany changes in your urine color:
- The change in urine color persist especially for up to 7 days
- Urine color is accompanied by other symptoms such as pain, headache, trouble with vision, rashes, changes in urination pattern, weight loss, pale or clay-colored stool, strong smell, yellow skin and eyes.
- There is visible blood in your urine and you are not menstruating. Blood in urine is pink, red, or brown (usually cola-colored). This could be a sign of kidney damage or disease, cancer, urinary tract infection or tissue injury.
- You are involved in strenuous exercises. Strenuous exercises can cause tissue damage and will also results to blood in urine.
Upon seeing a medical doctor, he or she will further collect your medical or family history and health habits such as smoking. This will be followed by some physical examination after which a laboratory test will be order to determine the exact cause of urine color change. Laboratory tests usually include urinalysis, blood test or urine culture.
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Treatment
Treatment varies and will depend on the outcome of your doctor’s examination together with your laboratory test.
If it’s due to dehydration, then you will be recommended to include more water in your diet. If it is diet, medication or vitamin supplement related, then no call for alarm. Everything should return to normal if you stop consuming these. But don’t stop taking medication because it causes a change in your urine color. Do so only if advised by your doctor.
If abnormal color change is due to an infection, a disease or condition, then you will be prescribed with the necessary medication or treatment plan to follow.
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Risk factors associated with urine color changes
Several factors can increase your chances of getting abnormal urine color. These include:
- Age: As we get older, our bodies and immune system becomes weaker. This makes us more prone to diseases or infections. For example, older people are more susceptible to getting cancer than the young.
- Sex: Men are susceptible to developing and enlarge prostate as well as prostate cancer and this can result to blood in urine. Women on the other hand are more prone to developing urinary tract infections (UTIs). About 60 % of women will develop a UTI during their life time. Among these, 1 in 4 will likely have a repeated infection.
- Family history: History always repeats itself when it comes to certain diseases one of which is kidney stones or kidney diseases. A family history of kidney stone will increase your chances of having the disease and this usually cause blood in urine.
- Strenuous exercises: Vigorous exercising may increase your risk of urinary bleeding. This is because it repeatedly damages your bladder or kidney with time causing blood to leak into urine.
- Eating habit: Most colored food such as berries contain intensely colored pigments. Frequent consumption of such foods may be reflected in your urine.
