By Medicover Hospitals / 18 Jan 2021
A feeling of being cold, but not necessarily in a cold environment, often accompanied by chills or tremors. The chills or tremors may have causes that are not due to an underlying disease. Examples include exposure to cold, fear, or nervousness.
- What is dark urine?
- Diagnosis and Treatment
- When to visit a Doctor?
What is dark urine?
Darkened urine is urine that is dark yellow, brown, dark red, or red, and can range from slightly dark to considerably dark. A change in urine color can be temporary or it can be persistent. The duration and progression of dark urine can vary significantly, depending on the cause.
There are several possible causes of dark urine. Urinary tract infection is the most common cause, although other types of infections or kidney dysfunction or disease are other potential causes. Darkened urine can be related to acute or chronic underlying diseases that affect other regions of the body. For example, urine that is darker than normal can be the result of liver disease that can include the gallbladder. Also, cancer of the pancreas, liver, kidneys, and bladder can cause urine to darken.
Your urine may turn dark if you have had any damage or injury to any of the structures of the urinary tract, including the kidney, bladder, urethra, or ureter. Urination can also darken due to the consumption of some foods, such as beets, red cabbage, berries, or candies, or ingesting anything that contains red dyes. Some medications are known to change the color of the urine, which will come back to normal once the medication leaves the body.
- Dark urine is usually a sign of dehydration. Dehydration occurs when the body runs out of water.
- It can cause dark urine and also:
- dry mouth and lips
- dizziness or weakness
- difficulty swallowing dry food
- Children, older adults, and people living with serious illnesses, such as cancer, are more prone to dehydration
- In most cases, people can treat dehydration by drinking more clear liquids, such as water and herbal teas.
- People should consult a physician if they have one or more of these symptoms:
- very dry mouth and tongue
- skin that recedes very slowly after pinching
- weak or absent pulse
- very low blood pressure
- minimal or no urine
Food, drink, or medicine:
- Some foods and drinks can cause changes in the color or smell of your urine.
- Beets and blackberries can make urine red, and eating rhubarb can cause a dark brown color or similar to tea.
- Some medications can also cause changes in the color of your urine:
- Senna, chlorpromazine, and thioridazine can produce red urine.
- Rifampin, warfarin, and phenazopyridine can produce orange-colored urine.
- Amitriptyline, indomethacin, cimetidine, and promethazine can produce blue or green urine.
- Chloroquine, primaquine, metronidazole, and nitrofurantoin can produce dark brown or tea-colored urine.
- Red blood cells develop in the bone marrow. The body usually destroys old or defective red blood cells in the spleen in a process called hemolysis.
- When the body mistakenly destroys too many red blood cells, a person can develop hemolytic anemia.
- Genetic blood disorders, such as sickle cell anemia or thalassemia, can also lead to hemolytic anemia. It is also a potential side effect of some medications and can sometimes occur after blood transfusions.
- Besides dark urine, symptoms of hemolytic anemia include:
- heart palpitations
- pale skin
- jaundice or yellow skin and eyes
- an enlarged spleen or liver
- In acute cases, hemolytic anemia may result in:
- back and abdominal pain
Urinary tract infections:
- Urinary tract infections (UTIs) occur when bacteria get into the bladder, typically through the urethra. Females tend to develop UTIs more frequently than males, and many people know them as bladder infections or cystitis.
- Symptoms of a UTI include:
- pain or burning when urinating
- pain or pressure in the abdomen
- frequent urges to urinate
- cloudy, dark, or bloody urine
- The hepatitis C virus (HCV) can cause a liver infection. It has few symptoms during the early stages, so many people don't know they have it until liver damage begins to cause problems. Because it affects the way the liver processes waste, HCV can cause dark urine.
- People who received a blood transfusion or organ transplant before July 1992 or a blood product for clotting problems manufactured before 1987 are at risk for HCV.
- Other risk factors include sharing needles, having sex without a condom with a person who has HCV, and getting tattoos with non-sterile equipment.
- If symptoms develop, they typically occur 2 weeks to 6 months after exposure to the virus. These are usually light and may include:
- sore muscles
- joint pain
- nausea or lack of appetite
- stomach ache
- skin itch
- dark urine
Diagnosis and Treatment:
- If you have dark urine that is not caused by dehydration or is a side effect of your medication, you will need a full evaluation by your doctor. They will need your detailed medical history and you will need to undergo a physical exam and urinalysis.
- A urinalysis involves taking at least a two-ounce sample of your urine. A laboratory will test your urine for the presence of several things, which could indicate the presence of an underlying medical condition. Examples include:
- red blood cells
- white blood cells
- A laboratory will give a report based on three components like:
- A visual exam will read if the urine is clear, cloudy, and concentrated, along with its color.
- Chemical tests include information on bilirubin, blood, ketones, protein, and glucose.
- A microscopic examination tests for the presence of bacteria.
- Ideally, the urine sample will come from the first urine you produce in the morning. This urine is more likely to show abnormalities because it is more concentrated than the other urine you produce during the day.
- If your urinalysis reveals unusual results, your doctor may order more specific tests. These tests may include blood tests or a urine culture, which try to identify the type of bacteria in your urine.
- Also, a complete blood count (CBC) or a complete metabolic panel can help your doctor identify if your kidney or liver function is compromised.
- Treatment will depend on your medical history, symptoms, and the results of any laboratory and other diagnostic tests.
When to visit a Doctor?
- People who show signs of severe dehydration should seek medical attention immediately, as the condition can cause serious complications.
- Anyone who thinks they may have a UTI should see a doctor for testing and possibly receiving antibiotics. Without treatment, the infection can spread to the renal.
- Anyone who suspects that they have been exposed to the hepatitis C virus (HCV) should speak to a healthcare professional about getting tested. The virus may cause severe liver damage if not treated.
Frequently Asked Questions:
Urine that is dark orange, amber, tail-colored, or brown can be a sign of liver disease. The color is because of excessive accumulation of bilirubin because the liver does not break it down normally.
Dark urine from food, drink, or medicine is usually not a cause for concern. The urine will go back to its normal color as soon as a person stops consuming what causes the change. Many mild cases of hemolytic anemia do not require treatment.
You should see a physician about your frequent urination if:
- Look for any of the other signs of diabetes above
- If you have bloody, red, or dark brown urine
- Urinating is painful
If you are dehydrated, you may notice that your urine is dark yellow or orange and smells like ammonia. Most people only experience mild dehydration and do not require medical treatment. Drinking more fluids, especially water, will generally return the smell of urine to normal.
Some liver and renal conditions and Urinary Tract Infections(UTI) can turn urine dark brown.
Causes of Dark Urine - https://jamanetwork.com/journals/jama/article-abstract/370316
Dark Urine Related to Metronidazole Therapy - https://jamanetwork.com/journals/jama/article-abstract/340284
Muscle cell injury, haemolysis and dark urine in children with falciparum malaria in Papua New Guinea - https://academic.oup.com/trstmh/article-abstract/100/9/817/1935763