All about pee! What your urine says about you

Our urine reveals a lot about our health. Nutritionist Cindy Williams reveals what’s normal and when we should do something about it.

We may not want to talk about it, but the state of our urine can reveal a lot about our health, and provide pointers to some potentially serious health conditions. Here are some signs you may notice, and what they mean.

Light colour

Pale coloured urine is diluted urine. It happens when we drink lots of fluids. Drinking plenty of water keeps our body hydrated and helps the kidney to do its waste filtration job without stress.

• Wha​t to do: There is no reason to worry unless you are bothered by frequent visits to the toilet.

Dark colour

If you don’t drink enough fluids, your urine will be concentrated and dark. People often notice this first thing in the morning if they haven’t drunk enough the day before. As an occasional symptom it is nothing to worry about, but continuous dehydration stresses out the kidneys and can cause damage.

Eating rhubarb or broad beans can turn urine brownish-black while blood from an infection, kidney problems or even cancer can also cause dark urine.

• What to do: Drink plenty of water to ensure you are well hydrated. If the dark colour remains for more than a few days, see your doctor. If you have dark-brown urine as well as pale stools and yellow eyes or skin, you may have a serious problem with your liver. See a doctor as soon as possible.

Sweet smelling

Urine that smells sweet is a classic sign of uncontrolled diabetes. When the level of glucose in the blood is too high, the kidneys try to get rid of the excess and it can end up in the urine.

• Wha​t to do: This is a serious symptom that needs to be checked out with your doctor.

Funny smelling

Asparagus is notorious for causing smelly urine. It contains sulphur compounds that make the toilet smell like a bad day in Rotorua. The urine may also have a green tinge. If you haven’t eaten asparagus, the smell could be a sign of an infection.

• What to do: If you haven’t eaten asparagus and the smell doesn’t go away, get yourself checked out at the doctor.

Bright yellow/purple

Riboflavin is a B vitamin that is also used as a food colouring. Just as it makes foods bright yellow, so it can stain your urine when you take it in the form of a multi-vitamin or B complex supplement. Carrots, carrot juice and vitamin C can stain your urine orange while beetroot, rhubarb and berries can stain it pink, red or purple. Not everyone reacts in this startling way. It depends on your particular body type and whether your urine is more acidic or alkaline. Certain medication can also turn urine a range of colours including brown, blue/green, red, or in the case of warfarin, orange.

• What to do: These bright colours are nothing to be concerned about unless they last more than a day or so. If the colour persists and you have stopped eating the suspect food or supplement, get it checked out.

Blood in the urine

Seeing blood in your urine is scary but not always serious. Strenuous exercise can traumatise the bladder and cause bleeding. So can some medications such as aspirin. A more serious cause is a urinary tract infection, reasonably common in young women.

Damage to the kidneys or bladder either through trauma such as a kick in the kidneys or through disease such as kidney or bladder stones or cancer may also cause blood in the urine.

• What ​to do: Unless you have just run a marathon, see your doctor to check for infection or something more sinister.

Burning sensation

If you have a urinary tract or prostate infection it can feel as though you are peeing razor blades.

• What to do: This needs treatment so see your doctor. The best treatment is antibiotics, rest and plenty of fluids.

Needing to go often

Running to the toilet all the time is often due to what we are drinking. The more fluids you drink, the more you have to go. Add alcohol or extra caffeine to your fluids and you will spend even more time peeing. Both caffeine and alcohol stimulate the bladder.

One of the symptoms of diabetes is frequent urination as the kidney tries to flush out the excess glucose from the blood. Infections of the urinary tract, kidney and bladder, as well as bladder cancer, all increase the need to go to the toilet.

As men head into their fifties and sixties their prostate enlarges. This squashes the urethra and partially blocks the flow of urine causing a weak flow and the need to go more often. Constipation can also stimulate the nerves around the bladder and increase urinary frequency.

Diuretic medication is designed to get rid of fluid from the body so if you are taking diuretics, you will need to go more often.

• What to do: Before you worry, check whether you are drinking more fluids, caffeine or alcohol than usual. Also check that you are eating enough high fibre foods and exercising regularly to avoid constipation. If you still need to go often, get a check-up to eliminate the more serious problems.

Leakage

‘Don’t make me laugh!’ If you have ever laughed so hard that you’ve wet your pants, you have experienced a moment of stress incontinence or leakage. It happens when the muscles that control urine flow and the pelvic floor muscles are weak and can’t handle the pressure from laughing, coughing, sneezing, jumping or lifting something heavy. Childbirth often weakens these muscles as does a chronic cough, some medications, being overweight and getting older. Men who have had their prostate removed may also suffer stress incontinence.

The other type of leakage is urge incontinence or overactive bladder. It’s as though the bladder has become a hyperactive teen, contracting its muscles at inappropriate times, sometimes when it is hardly full, giving you just moments to get to the toilet. Urge incontinence is caused by anything that damages the nerves or irritates or obstructs the bladder such as infection, bladder stones, cancer, or an enlarged prostate.

Spicy foods, carbonated drinks, caffeine and acidic foods such as citrus can also irritate the bladder. This potentially embarrassing problem is more common as we age, and for women especially after menopause when oestrogen levels drop. Oestrogen keeps the tissues around the bladder and urethra strong and healthy, and also enhances nerve function. People with Parkinson’s disease, Alzheimer’s, stroke or multiple sclerosis where the bladder nerves are damaged are also prone to leakage.

If you feel as though your bladder is never quite empty and you often dribble urine, you may have overflow incontinence. This occurs in men with prostate problems or people with a damaged bladder, blocked urethra or nerve damage from diabetes.

• What to do: Do pelvic floor exercises regularly. For urge incontinence, see a doctor or physiotherapist who specialises in bladder retraining.
• Your doctor may also prescribe medication. Some women find that topical oestrogen cream helps although the research is not definitive about this. Drink fluids, but not to excess. Stick to a normal amount of water (six to eight glasses a day) and spread this drinking evenly through the day. Some people think they can control their symptoms by not drinking. But less fluid means more concentrated urine which also irritates the bladder.
• Cut back on spicy foods, caffeine, alcohol, carbonated drinks and citrus to reduce bladder stimulation.
• For stress incontinence, quit smoking and lose weight if necessary.

Foamy

Slightly foamy urine is usually a sign of mild dehydration. However, if it continues and worsens, it may be protein leaking from the kidney.

• What to do: Drink plenty of water. If it persists, ask your doctor to check your kidney function.

What’s ideal?

Our urine should ideally be a pale yellow colour. This tells us that we are drinking enough fluid to keep our urine well diluted which keeps our kidneys happy and healthy.

Our kidneys produce around 1.5 litres (six to seven cups) of urine each day. When the bladder has filled up about a cup it sends out a signal that it’s time to go. It can actually hold over three cups of urine so we have plenty of time to get ourselves to a toilet. Anything from four to eight trips to the toilet in a 24-hour period is normal. The more you drink, the more trips to the toilet.

Are you dehydrated? Download this handy pee chart to find out.