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Why is my pee black?

Dark urine is most commonly due to dehydration. However, it may be an indicator that excess, unusual, or potentially dangerous waste products are circulating in the body. For example, dark brown urine may indicate liver disease due to the presence of bile in the urine.

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Overview Dark urine is deeper in color than urine that is usually straw to yellow in color. Darker urine can be different colors, but is usually brown, deep yellow, or maroon. Urine is produced in the kidneys. When you take in fluid or food, it passes from your digestive system, into your circulatory system, and into your kidneys where it is filtered. The kidneys then get rid of waste products and extra fluid through the urine. The ureters are tubes that connect the kidneys to the bladder. The bladder empties the urine via the urethra, the tube you urinate through. Ideally, your urine would be a pale yellow in color. This would indicate you’re hydrated. Urine naturally has some yellow pigments called urobilin or urochrome. The darker urine is, the more concentrated it tends to be. Dark urine is most commonly due to dehydration. However, it may be an indicator that excess, unusual, or potentially dangerous waste products are circulating in the body. For example, dark brown urine may indicate liver disease due to the presence of bile in the urine. Bloody, or reddish-colored, urine, is an indication of other potential problems, including direct injury to the kidneys. If you have these symptoms, it’s important to see a doctor. Outside factors that affect urine Sometimes dark urine doesn’t have anything to do with hydration or overall health. Instead, it’s related to something you ate or drank or a medicine you took. If your urine is dark, think back to what you’ve eaten. If you’ve had beets, berries, rhubarb, or fava beans, these can all cause your urine to appear dark. Some medications can cause dark urine. Usually your doctor will let you know beforehand that this is a possible side effect. Some examples of medicines known to do this include: laxatives with senna

chemotherapy drugs

rifampin

warfarin (Coumadin)

phenazopyridine

When to call your doctor You should seek medical attention if you see blood in your urine or experience dark urine that does not go away after drinking water. It’s very important to know the exact cause of your symptoms. If you have dark urine accompanied by intense pain, especially in your back, you may have kidney stones or a urinary tract infection (UTI). If you can’t see your doctor right away or if the pain and any other symptoms get worse or are accompanied by nausea, vomiting, and a high fever, seek immediate medical attention. Diagnosis and treatments If you’re experiencing dark urine that isn’t caused by dehydration or is a side effect of your medication, you’ll need to have a comprehensive evaluation by your doctor. They will need your detailed medical history and you will need to have a physical examination and urinalysis. A urinalysis involves taking at least a two-ounce sample of your urine. A laboratory will test the urine for the presence of several things, which could indicate the presence of an underlying medical condition. Examples include: bacteria

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bilirubin

crystals

glucose

protein

red blood cells

white blood cells A lab will give a report based on three components. A visual exam will read if the urine is clear, cloudy, and concentrated, along with its color.

Chemical tests include information about bilirubin, blood, ketones, proteins, 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 most likely to show abnormalities if there are any because it is more concentrated than other urine you produce over the day. If your urinalysis reveals unusual results, your doctor may order more targeted tests. These tests may include blood testing or a urine culture, which attempt to identify the type of bacteria in your urine. Also, a complete blood count (CBC) or comprehensive 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 studies and other diagnostic tests.

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