What the Color of Your Pee Says About You

Every time you flush the toilet after urinating, you are also flushing away an important clue about your health. What color is your urine today? We can tell a lot about our health when it comes to the color of our pee.

Why does the color of our urine change?

Urine gets its color primarily from urochrome (aka, urobilin), a pigment that causes urine to range in color from pale yellow to a deep amber. The more water you consume, the more diluted your urine will be, and thus the paler yellow it will appear. If you drink a lot of water, your urine may even appear to be clear. However, the color of “normal” urine falls somewhere on this spectrum.

The color of urine is also influenced by other factors, as shown here. It may be helpful to check out this chart to recognize different colors of pee the next time you check out the toilet bowl.

Diet. Did you have beets for dinner? Don’t be alarmed when you see a pinkish or reddish tinge later at night or the next morning. Beets are just one food that may change the color of your urine, along with berries, carrots, rhubarb, asparagus, and fava beans. Processed foods that contain a lot of food dyes or colorings are other culprits, as may be meal replacement shakes, which can have a high vitamin B content. 

Supplements. Various vitamins, including the B vitamins riboflavin and cobalamin (B2 and B12, respectively) may cause your urine to turn a fluorescent yellow-green. High intake of vitamins C or beta-carotene may leave you with dark yellow or orange pee.

Exercise. Physical activity can impact urine color in several ways. If you exercise and don’t drink enough fluids, especially in heated environments, you can become dehydrated, which can cause highly concentrated urine that is dark amber or the color of tea. This is a serious medical condition and should be treated immediately. Some athletes exercise so vigorously they see some blood in their urine, which may appear as pinkish or reddish pee. This is typically a temporary condition but should be explored by a doctor if it continues for more than 24 hours, as red urine may be a sign of a something more serious.

Medications. Both over-the-counter and prescription medications may alter the color of your urine temporarily or longer term. Some drugs that may change pee color to dark yellow, orange, green, or brown (depending on the drug) are antibiotics, alpha-methyldopa and L-dopa, rifampin, laxatives that contain senna or cascara, phenazopyridine, sulfasalazine, amitriptyline, indomethacin, propofol, chloroquine, primaquine, methocarbamol, promethazine, cimetidine, amitriptyline, metoclopramide, and indomethacin.

Medical conditions. The presence of a kidney, bladder, urinary tract, or liver infection may turn your urine brown or even green in the case of urinary tract infections caused by Pseudomonas bacteria. Men who have an enlarged prostate may experience pinkish or reddish urine. Both urinary tract infections and kidney stones may cause your urine to look murky or whitish, same with deposits of calcium or phosphate crystals or mycobacterial infection.

In rare cases, bladder or kidney tumors can affect the color of your urine, as may cancer. Blue urine is associated with a rare inherited disorder known as familial benign hypercalcemia. 

Diagnosing color changes in urine

Changes in urine color are often harmless, but if it continues or you are experiencing symptoms such as fever, pain, or mental confusion, you should see your doctor as soon as possible. Think about the answers to the following questions, as your doctor will want to know:

• When did you first notice the color change
• What medications or supplements are you taking
• What have you been eating or drinking
• Have you participated in strenuous exercise
• Have you experienced any rashes, problems with vision, unexplained weight loss, headaches, or bowel movement problems
• Have your urinary habits changed

Your doctor may want to perform a urinalysis or blood test depending on your symptoms and the answers to these and other questions. A urinalysis can identify substances in your pee, such as proteins, red blood cells, and infection-causing bacteria. A blood test can determine the levels of liver enzymes and measure kidney function, which may help identify any problems with these organs.