What Your Urine Says About Your Health
All too often, the emphasis is placed on our intake. We are what we eat, they tell us. The sheer number of health crazes and diet fads certainly suggests we only need to focus on what we put in our bodies.
However, checking what we output is just as important: Our urine can reveal a lot about our overall health.
How urine is produced
After the body has absorbed nutrients for nourishing our cells and providing energy, it excretes whatever is left, as well as the toxins and wastes built up in cells and organs.
The urinary system—composed of the kidneys, renal pelvis, ureters, bladder and urethra—has a number of important functions, such as filtering out toxins and wastes, regulating blood volume and blood pressure, regulating the pH of your blood, and controlling the level of electrolytes and metabolites.
Its main function is to eliminate waste from the body. Once the kidneys filter the blood, the waste product—urine—travels down the ureters to the urinary bladder, and is stored there until it is expelled.
The urinary system is very similar in both sexes. The male urethra is longer, as it travels the entire length of the penis, and is used not only for urination but also for the ejaculation of sperm.
Evaluating your urine
In a medical setting, urine testing is generally a diagnostic tool. A urine panel, also known as a urinalysis, is often ordered along with a blood panel at the onset of diagnosis and treatment.
Former emergency room nurse Deidre Campbell advised to "always look at our urine to establish our individual baseline for what is normal." Urine is evaluated by output, color and smell. Healthy output is considered to be around 30 ml per hour. Normal urine is clear and light yellow in color and has no odor.
Barbara Choute, a nurse at a specialty cardiac center based in Florida, illustrated what normal looks like for her: Choute routinely works a 12-hour shift starting at 7 a.m., and says she urinates roughly two to three times per day. Her output is generally 300 to 400 ml per bathroom visit, totaling around 1,500 ml per day.
Choute said this output is normal for someone with good functioning kidneys who maintains regular hydration throughout the day. If a person starts to significantly increase fluid intake and has properly functioning kidneys, there will be a corresponding increase in urine output. Similarly, certain foods will also affect the color and smell of your urine.
Murray, a 37-year-old liver transplant recipient, monitors his urine as part of his routine care. He recalled a period prior to his transplant when his urine was "really dark, like the color of Pepsi." That was his norm for months. Now, three years post-transplant, he mostly monitors his urine for output and color.
"Medication will have an effect on my kidneys in the long run, so I have to monitor for any change," Murray said.
He is consciously on alert for a decrease in output, even when his fluid intake hasn't changed, and if his urine gets significantly darker while he's properly hydrated.
Diabetic patients are encouraged to monitor their urine, along with their blood sugar levels.
"A blood sugar level higher than 250 mg/dl should trigger a dipstick test of the urine for ketones," Campbell said.
If high ketone levels are ascertained, the diabetic patient will know they need to drink water and retest. Campbell emphasized that monitoring ketones in diabetes patients is critical: Increasing ketone levels is a sign of diabetic ketoacidosis, which can possibly lead to coma and death if not immediately addressed.
Red flags to look out for
Choute remarked that regarding output, concern is warranted if patients are classified as anuric or oliguric. An anuric patient is usually on dialysis, as they are producing no urine and need to have their blood filtered through dialysis. An oliguric patient will also have kidney disease and their urine output will be small, less than 400 ml per day. Choute said that if your fluid intake is normal but you're not seeing urine output of at least 800 ml per day, it may be cause for concern.
Choute noted someone could have a functioning kidney with regular fluid intake and see frequent trips to the bathroom. She said that in these cases, the actual total urine output may not increase, just the frequency of urination, which could indicate an overactive bladder. Conversely, reduced frequency in urination, especially for older men, may not always point to kidney function. An enlarged prostate in older men will affect urine flow and frequency. This condition is called benign prostatic hyperplasia.
A change in urine color may also be a red flag. Urine that is yellow and cloudy—that is, it has sediments—accompanied by a foul odor may be an indication of an infection. This can range from being a urinary tract infection (UTI) to an infection of the genitals and/or kidneys. A brown tinge in the urine could be an indication of kidney or bladder dysfunction.
Urine that is yellow and cloudy—that is, it has sediments—accompanied by a foul odor may be an indication of an infection.
Hematuria, or bloody urine, is always a serious warning sign, but it may be from trauma resulting from a necessary procedure. Choute explained that placement of a Foley catheter—a tube inserted into the bladder to drain urine—especially in men, may encounter some resistance. If the insertion procedure is not carried out correctly, this can cause trauma and result in patients seeing some blood in the urine.
As a rule, though, always talk to your doctor if you see blood in your urine because any underlying health issue should be ruled out.
A painful or burning sensation when urinating should also sound an alarm. Usually, this represents a sign of a sexually transmitted disease (STD), such as chlamydia or gonorrhea. Both infections, while uncomfortable, can be treated upon diagnosis, so immediate testing is recommended.
General awareness of one's body is key to maintaining good health and recognizing warning signals. Knowing what your urine says about your general health is extremely important. Daily monitoring of your pee can literally save your life.
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