Dark Colored Urine Overview
Normal urine color ranges from pale yellow to deep amber color, the result of a pigment called urochrome and how diluted or concentrated the urine is.
Many different things, including some medical conditions, can affect the color of urine. Most of these are harmless, but a change in color can sometimes signal a health problem.
Pigments and other compounds in certain foods and medications can change your urine color. Beets, berries and fava beans are among the foods most likely to affect the color. Some of over-the-counter and prescription medications give urine vivid tones, such as red, yellow or greenish blue.
An unusual urine color can be a sign of disease. For instance, deep red to brown urine is an identifying characteristic of porphyria, a rare, inherited disorder of red blood cells.
Symptoms
Normal urine color varies, depending on how much water you drink. Fluids dilute the yellow pigments in urine, so the more you drink, the clearer your urine looks. When you drink less, the color becomes more concentrated. Severe dehydration can produce urine the color of amber.
But urine can turn colors far beyond what’s normal, including red, blue, green, dark brown and cloudy white.
Causes of Dark Colored Urine
Discolored urine is often caused by medications, certain foods or food dyes. In some cases, though, changes in urine color can be caused by specific health problems.
The color categories here are approximate, because what looks like red to you might look like orange to someone else.
Blue or Green Urine
Blue or green urine can be caused by the following:
- Dyes: Some brightly colored food dyes can cause green urine. Dyes used for some tests of kidney and bladder function can turn urine blue.
- Medications: A number of medications produce blue or green urine, including amitriptyline, indomethacin (Indocin, Tivorbex) and propofol (Diprivan).
- Medical conditions: Familial benign hypercalcemia, a rare inherited disorder, is sometimes called blue diaper syndrome because children with the disorder have blue urine. Green urine sometimes occurs during urinary tract infections caused by pseudomonas bacteria.
Cloudy or Murky Urine
Urinary tract infections and kidney stones can cause urine to appear cloudy or murky.
Dark Brown or Cola-Colored Urine
Brown urine can result from the following:
- Food: 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 antibiotics metronidazole (Flagyl) and nitrofurantoin (Furadantin), laxatives containing cascara or senna, and methocarbamol , which is a muscle relaxant.
- Medical Conditions: Some liver and kidney disorders and some urinary tract infections can turn urine dark brown.
- Extreme exercise: Muscle injury from extreme exercise can result in pink or cola-colored urine and kidney damage.
Red or Pink Urine
Despite its alarming appearance, red urine isn’t necessarily serious. Red or pink urine can be caused by:
- Blood: Factors that can cause urinary blood (hematuria) include urinary tract infections, an enlarged prostate, cancerous and noncancerous tumors, kidney cysts, long-distance running, and kidney or bladder stones.
- Foods: Beets, blackberries and rhubarb can turn urine red or pink.
- Medications: Rifampin (Rifadin, Rimactane), an antibiotic often used to treat tuberculosis, can turn urine reddish orange — as can phenazopyridine (Pyridium), a drug that numbs urinary tract discomfort, and laxatives containing senna.
Cirrhosis
Brown urine can also be a symptom of cirrhosis. That is the name for scars on the liver that form after you’ve been living for years with hepatitis or other types of liver disease.
Early cirrhosis might not cause symptoms, but in advanced stages, it can cause brown urine as well as:
- Difficulty concentrating
- Poor memory
- Muscle weakness
- Trouble sleeping
- Water retention in the belly or legs
- Yellow skin or eyes
Brown urine, especially along with yellow skin or eyes, can also be a sign of many other liver problems. If you have these symptoms, see your doctor.
Dehydration
Dark urine is usually a sign of dehydration. Dehydration occurs when there is not enough water in the body.
It can lead to dark urine as well as:
- Abnormal thirst
- Constipation
- Dry mouth and lips
- Fatigue
- Dizziness or weakness
- Trouble swallowing dry food (Dysphagia)
Children, older adults, and people living with severe illnesses, such as cancer, are more prone to dehydration.
In most cases, people can treat dehydration by drinking more clear fluids, such as water and herbal tea.
People should seek medical advice if they have any, some, or all of the following symptoms:
- Lethargy
- Very dry mouth and tongue
- Skin that moves back very slowly after being pinched
- Weak or absent pulse
- Very low blood pressure
- Minimal or no urine
Food, Drinks, or Medication
Some foods and drinks can cause a change in the color or smell of urine.
Beets and blackberries can turn the urine red and eating rhubarb can result in a dark brown or tea-like color.
Medications
Some prescription drugs can cause brown urine.
These include:
- Antibiotics
- Muscle relaxants
- Antimalarial drugs
- Laxatives
Some other medications can also cause changes in urine color:
- Amitriptyline, indomethacin, cimetidine, and promethazine can result in blue or green urine.
- Chloroquine, primaquine, metronidazole, and nitrofurantoin can result in dark brown or tea-colored urine.
- Rifampin, warfarin, and phenazopyridine can result in orange urine.
- Senna, chlorpromazine, and thioridazine can result in red urine.
Hemolytic Anemia
Red blood cells develop in the bone marrow. The body usually destroys old or faulty red blood cells in the spleen in a process called hemolysis.
When the body mistakenly destroys too many red blood cells, a person might develop hemolytic anemia.
Genetic blood disorders, such as sickle cell disease or thalassemia, can also lead to hemolytic anemia. It is also a potential side effect of some medicines and can sometimes occur after blood transfusions.
In addition to dark urine, symptoms of hemolytic anemia include:
- A headache
- Fatigue
- Dizziness
- Enlarged liver (hepatomegaly) or spleen
- Heart palpitations
- Jaundice, or yellowing skin and eyes
- Pale skin
In severe cases, hemolytic anemia can lead to the following conditions:
- Abdominal pain
- Back pain
- Chills
- Fever
- Shock
Hepatitis C
The Hepatitis C virus (HCV) can cause an infection of the liver. It has few symptoms during the early stages, so many people do not know they have it until liver damage starts causing problems. Because it affects how the liver processes waste, HCV may cause dark urine.
People who received a blood transfusion or organ transplant, or a blood product for clotting problems are at risk of having HCV.
Other risk factors include sharing needles, having sex without a condom with a person who has hepatitis C virus, and receiving tattoos using unsterile equipment.
Symptoms of hepatitis C usually appear within 2 weeks to 6 months of exposure to the virus. They are generally mild and may include the following conditions:
- Dark urine
- Fatigue
- Fever
- Itchy skin
- Jaundice
- Joint pain
- Nausea
- Poor appetite
- Sore muscles
- Stomach pain
Intense Exercise
In rare cases, intense exercise can cause muscle cells to burst and leak into the bloodstream. This condition is called rhabdomyolysis, or “rhabdo,” and it can turn the urine brown.
If you have brown urine because of rhabdo, you might also notice:
- Muscle aches
- Muscle weakness
Rhabdo can cause serious kidney damage and can be life-threatening.
Kidney Disease
Some kidney diseases can cause brown urine. For example, a kidney infection called post-streptococcal glomerulonephritis (PSGN) can turn your urine a reddish-brown color. This infection happens after strep throat and most often in children.
If kidney disease is the cause of your brown urine, you might also have symptoms like:
- Feeling tired
- Swelling in the face, and around the eyes, in the hand and feet
- Less of a need to urinate, or less urine when you do
Skin Cancer
Melanoma can sometimes cause skin pigment to leak into the bloodstream, though it’s rare. This can lead to brown urine.
The more common signs of melanoma are changes to moles. You should see a doctor for any skin abnormality that is growing or changing quickly and doesn’t go away.
Tick-Borne Disease
Some ticks carry a bacteria that causes a serious infection called babesiosis. One of the symptoms is dark urine.
Urinary Tract Infections (UTIs)
Urinary tract infections (UTIs) happen when bacteria get into the bladder, usually through the urethra. Women tend to develop UTIs more often than men, and many people know them as bladder infections or cystitis.
Symptoms of a UTI include:
- Pain or burning while urinating
- Frequent urge to urinate
- Pain or pressure in the abdomen
- Urine that is cloudy, dark, or appears bloody
Treatment
Individuals experiencing severe dehydration may need rehydration therapy. This process usually involves administering oral rehydration salts or fluids and electrolytes in the hospital.
Dark urine due to food, drink, or medications is not usually a cause for concern. The urine will return to its normal color once an individual stops consuming whatever is causing the change in urine color.
Most mild cases of hemolytic anemia do not require treatment. For others, lifestyle changes can help control the signs and symptoms.
In severe cases of hemolytic anemia, blood transfusions, blood and bone marrow transplants, or surgery to remove the spleen may be required.
Doctors will usually prescribe a short course of antibiotics to treat UTIs. Patients with a severe infection may require a longer course of antibiotics. Some patients may take pain relievers.
For many years, HCV treatments carried various potential side effects. However, new therapies can help treat many forms of the virus without severe side effects.
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