Report on Urine Colors by AskDocWeb

Urine Colors

One way to monitor changes in your health is to pay attention to the color of your urine. Changes in the color of your urine are normal and occur for a verity of reasons, most of them harmless. This page examines the reasons for the various colors you might see in your urine.

Red Urine or Pink Urine

Red urine is not necessarily bloody urine. Despite its alarming appearance, red urine isn’t necessarily serious but it does need to be evaluated to see if it contains blood. If it does then you may be referred to a urologist for an evaluation of the cause.

Factors that can cause blood in the urine, known medically as hematuria, range from strenuous exercise, urinary tract infections, enlarged prostate, kidney stones, bladder stones, kidney disease, and, occasionally, bladder cancer, kidney cancer, or just menstrual blood. More often it is caused by one of the following:

  • Foods: Beets, including beet soup (Borscht), tomato sauce, red licorice, red wine, blackberries, rhubarb, and food coloring can turn urine red or pink.
  • Medications causing red colored urine: Certain laxatives (Ex-lax) can cause red urine. Several prescription drugs have this effect including rifampicin, pyridium, antipsychotics such as chlorpromazine and thioridazine and the anesthetic propofol (Diprivan). Iron supplements, Pepto-Bismol, and Maalox are also known to cause red urine.
  • Medications causing blood in urine: Over-the-counter medications containing NSAIDs can cause bleeding in the urinary and digestive tract. Drugs and chemicals like anticoagulants, cyclophosphamide disulfiram, halothane, isoniazid, ketoconazole, methyldopa, niacin, nitrofurantoin, oral contraceptives, propylthiouracil, rifampin, testosterone, warfarin can cause internal bleeding that result in red urine.
  • Toxins: Chronic mercury or lead poisoning can cause urine to turn red. This may result from high levels of porphyrins excreted in the urine. This is the same pigment that discolors urine in people who have porphyria, a genetic abnormality of metabolism causing abdominal pains and mental confusion.

The cause of red urine usually isn’t severe and typically occurs without other signs or symptoms.

Orange Urine

Orange urine is pretty hard to miss and most often it has one of the following causes:

  • Foods and supplements: Vitamin C is almost famous for turning urine orange and that is to be expected. Orange foods like carrots and carrot juice can also do that. Large amounts of carotene, the orange pigment in carrots, winter squash and other vegetables, can also give the palms of your hands and the soles of your feet an orange color.
  • Medications: Medications that can turn urine orange include the antibiotic rifampin (Rifadin), the blood thinner warfarin (Coumadin), doxorubicin (Adriamycin, Rubex), phenazopyridine (Pyridium), some laxatives and certain chemotherapy drugs.
  • Dehydration: Not drinking enough fluids can concentrate urochrome, which results in urine with a much deeper color.
  • Dark orange urine can also be a sign of medical problems such as jaundice, Gilbert’s syndrome, or urinary infection. Warning signs that need to be reported to your doctor include:

    • Abdominal pain that comes in waves
    • Burning pain with urination
    • Fever, chills, sweats
    • Frequent urination
    • Persistent urge to urinate
    • Strong-smelling urine (normal urine should have little or no odor)

Note that the darker your urine the more likely you are to be dehydrated. This is something to watch for, especially during hot weather or if you work up a sweat frequently.

Green Urine

Yes, your urine may even turn green. Foods like asparagus can give urine a greenish tinge as well as a characteristic odor.

Blue Urine

Medications: There are a number of medications tht may produce blue urine, including amitriptyline, indomethacin (Indocin), cimetidine (Tagamet), the anti-nausea drug Phenergan and several multivitamins. A dye used in several medications that treat urinary pain (Urised, others) can turn urine blue.

Medical conditions: Familial hypercalcemia is a rare inherited disorder that may cause blue urine. It is sometimes called blue diaper syndrome because children with this disorder have blue urine.

Dark brown or tea-colored urine

Foods and supplements: Eating large amounts of fava beans, rhubarb or aloe can cause dark brown urine.

Medications: A number of drugs can darken urine, including the antimalarial drugs chloroquine and primaquine; the antibiotic metronidazole; nitrofurantoin, which treats urinary tract infections; laxatives containing cascara or senna; and methocarbamol, a muscle relaxant.

Medical conditions: Some liver disorders, especially hepatitis and cirrhosis, and the rare hereditary disease tyrosinemia can turn urine dark brown. So can acute glomerulonephritis, a kidney disease that interferes with the kidney’s ability to remove excess fluid and waste.

Cloudy or Murky Urine

Urinary tract infections and kidney stones can cause urine to appear cloudy or murky.

Purple Urine

A rare inerited disorder of red blood cells called porphyria can turn the urine color a deep purple.

Normal Urine Color

So what is the normal color for urine? It is normal for urine to range from a pale yellow to deep amber. It is also normal for your urine to vary in color over time. This occurs because of changes in diet, which includes any supplements or medication you take as well as the liquids you consume.

Changes in urine color may indicate a developing medical problem. Just because you have eaten a food that turns your urine red does not rule out the possibility of a medical problem.

If an unusual color appears in your urine, monitor it closely and if it persists for more than a day, consult with your doctor.

References

  • Ferri FF. Ferri’s Differential Diagnosis: A practical guide to the differential diagnosis of symptoms, signs and clinical disorders. 2nd ed. Philadelphia, Pa.: Mosby Elsevier; 2011:82
  • American Cancer Society: B-Complex Vitamins
  • Foot CL, et al. Uroscopic rainbow: Modern matula medicine. Postgraduate Medical Journal. 2006;82:126
  • Medline Plus: Urine Abnormal Color, August 2009
  • Castle EP (expert opinion). Mayo Clinic, Rochester, Minn. July 5, 2011
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