What are Dark Urine?

Various Potential Symptoms and Causes of Dark Urine

The most common cause is a urinary tract infection, but other infections or kidney dysfunction/disease can also lead to darkened urine. Additionally, dark urine can be a result of acute or chronic diseases affecting different parts of the body. For instance, liver disease, including gallbladder issues, can cause urine to be darker than usual. Furthermore, cancers of the pancreas, liver, kidneys, and bladder can also contribute to darkened urine.

Dark urine may also occur if the urinary tract structures, such as the kidney, bladder, urethra, or ureter, have been damaged or injured. Certain foods, like beets, red cabbage, berries, or candies, and substances containing red dyes, can darken urine. Additionally, certain medications are known to alter the colour of urine, but this change is usually temporary and will revert to normal once the medication is eliminated from the body.

One common cause of dark urine is dehydration. When the body lacks sufficient water, urine can become dark. Dehydration can also lead to symptoms like dry mouth and lips, thirst, dizziness or weakness, difficulty swallowing dry food, constipation, and fatigue. Individuals who are more susceptible to dehydration include children, older adults, and those with severe illnesses like cancer.

In most cases, increasing fluid intake by drinking clear liquids such as water and herbal teas can help treat dehydration. However, if symptoms like lethargy, parched mouth and tongue, slow skin receding after pinching, weak or absent pulse, shallow blood pressure, or minimal/no urine are present, it is advisable to consult a physician.

Certain types of food and beverages can change the colour and smell of urine. For example, consuming beets and blackberries can make urine appear reddish, while rhubarb can give it a dark brown colour similar to tea. Similarly, certain medications can also affect the colour of urine.

Medications like Senna, chlorpromazine, and thioridazine can cause urine to turn red. Rifampin, warfarin, and phenazopyridine may make urine appear orange. On the other hand, medications like amitriptyline, indomethacin, cimetidine, and promethazine can result in the production of blue or green urine. Lastly, chloroquine, primaquine, metronidazole, and nitrofurantoin have the potential to darken urine, making it look like tea or dark brown.

Hemolytic anaemia occurs when the body mistakenly destroys an excessive number of red blood cells, leading to a deficiency. Normally, red blood cells are produced in the bone marrow and eliminated in the spleen through a process called hemolysis. However, when this process malfunctions, hemolytic anaemia can develop. This condition can be caused by genetic blood disorders such as sickle cell anaemia or thalassemia, as well as certain medications or even blood transfusions.

In addition to dark urine, individuals with hemolytic anaemia may experience symptoms such as tiredness, lightheadedness, irregular heartbeats, pale skin, headaches, jaundice (yellowing of the skin and eyes), and an enlarged spleen or liver.

In severe cases, acute hemolytic anaemia can present with symptoms like coldness, fever, back and abdominal pain, and even shock. Urinary tract infections, also known as UTIs, occur when bacteria enter the bladder through the urethra. They are more common in females than males and are often referred to as bladder infections or cystitis.

Symptoms of a UTI include pain or burning during urination, abdominal pain or pressure, frequent urges to urinate, and cloudy, dark, or bloody urine.

Hepatitis C is a virus that can cause liver infections. In the early stages, it may not show many symptoms, leading many people to be unaware of their condition until liver damage occurs. Hepatitis C affects the liver's ability to process waste, which can result in dark urine. Those at risk for HCV include individuals who received blood transfusions or organ transplants before July 1992 or blood products for clotting problems manufactured before 1987.

Other risk factors include sharing needles, having unprotected sex with someone who has HCV, and getting tattoos with non-sterile equipment. Symptoms of HCV may include fatigue, sore muscles, joint pain, fever, nausea lack of appetite, stomach ache, skin itch, dark urine, and jaundice.

If you have dark urine that is not caused by dehydration or medication side effects, it is important to undergo a full evaluation by your doctor.

This will involve providing a detailed medical history, undergoing a physical examination, and a urinalysis. A urinalysis involves testing a sample of your urine for various substances that could indicate an underlying medical condition, such as bacteria, bilirubin, crystals, glucose, protein, red blood cells, and white blood cells.

The laboratory will provide a report based on the visual examination of the urine's clarity, colour, and concentration, as well as chemical tests for bilirubin, blood, ketones, and protein.

Diagnosis and Treatment of Dark Urine

If you are experiencing dark urine that is not due to dehydration or a side effect of medication, it is important to seek a comprehensive evaluation from your physician. Your doctor will require a thorough medical history from you and conduct a physical examination as well as a urinalysis.

During a urinalysis, a minimum of a two-ounce urine sample will be collected. The laboratory will analyze your urine for various substances that may indicate an underlying medical issue. These substances include:

• Bacteria
• Bilirubin
• Crystals
• Glucose
• Protein
• Red blood cells
• White blood cells
• The laboratory will provide a detailed report based on the following three main components:
• A visual examination to assess the clarity, cloudiness, concentration, and colour of the urine.
• Chemical tests to detect bilirubin, blood, ketones, protein, and glucose.
• Microscopic examination to identify the presence of bacteria.

When to Visit a Doctor?

It is essential to consult a doctor under certain circumstances.

For instance, individuals displaying symptoms of severe dehydration should promptly seek medical assistance to prevent potential complications.

Similarly, those who suspect a urinary tract infection (UTI) should visit a doctor for proper testing and potential antibiotic treatment. Neglecting to address a UTI may result in the disease spreading to the kidneys. Moreover, individuals who believe they have been in contact with the hepatitis C virus (HCV) should consult a healthcare provider to undergo testing. Failure to treat HCV may lead to significant liver damage.