Sherry Haynes is currently pursuing a PharmD degree and has experience in both the clinical and management sides of pharmacy.
The appearance and odor of urine can be an indicator of your lifestyle and health. This was how doctors of the eighteenth century diagnosed illness of their patients. But since urine analysis have advanced so much this is not practiced anymore. It might now only mean a sign to patients regarding their health.
Medications, food, dyes, pigments, and some poisons like phenol can change the color of urine anything from red to green.
It might be disconcerting for people to see the color of urine change as it does not happen usually. But the good news is that at most times the cause of the color change is harmless for example, when it is due to medications or dyes. But, it can be a sign of an underlying disease and should not be ignored especially if you do not suspect any other cause. In such case please contact a GP immediately.
The normal color of the urine ranges from light yellow to dark amber depending on the concentration of the urine. A pigment called urochrome and to a lesser extent, urobilin and uroerythrin gives urine its color. Hemoglobin, myoglobin, bilirubin, and uric acid are other pigments present inside our body that may also change the urine color.
The list provided below indicates most common causes of urine color change.
Yellow colored urine is used as an indicator of dehydration for patients in the ICU. Dehydration is most possible cause of yellow urine. Not drinking enough water can make your urine concentrated and make it turn dark yellow. Drinking more fluids can bring the condition to normal.
Medical conditions like diabetes, hypothyroidism, infection with Serratia marcescens are some other causes.
Orange Colored Urine
Orange color of urine is usually caused by precipitation of uric acid in the urine.
Dehydration or a problem with liver or bile duct may be the reason. Orange color urine was also observed in Citrobacter infection cases before.
Medications such as Phenazopyridine, Phenolphthalein, Rifampicin, Vitamin B2 (Riboflavin) , Vitamin C, Warfarin, Isoniazid, parkinson's meds (tolcapone, entacapone) can give urine orange appearance.
Eating a lot of beets and carrots can also change the color of urine.
Milky White / Foamy
Milky appearance of urine is commonly caused due to chyluria, a condition in which chyle is present in the urine. It is usually caused in filariasis infection but can also have other causes not related to infections. The drug Propofol can also give a milky appearance to urine.
It may indicate excess proteins or excess phosphates in your diet.
Food such as beets, blackberries, rhubarb, and senna may cause urine color change to any shade of red and orange. Colorings used in food such as Aniline congo red rhodamine B may also cause red color urine.
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Medications: Azosulfamide, Azuresin, Anthraquinone, Chlorpromazine, Chloroquine, Deferoxamine, Hydroxocobalamin, Ibuprofen, Iron injections, Metronidazole, Nitrofurantoin, Phenazopyridine, Phenyl salicylate, Phenytoin, Phenolphthalein when used to loosen stools, Phenothiazines, Rifampicin.
Medical conditions: Citrobacter and Serratia infections, G6PD deficiency, sickle cell anemia, thalassemia, and transfusion reactions.
Phorphyria due to presence of porphyrin pigments in the urine is a harmless cause.
Note: Red urine most commonly results from blood in the urine (hematuria) . In fact a single drop of blood can make urine appear red. Blood in urine can be caused due to lead or mercury poisoning, kidney or bladder stone, urinary tract infection, tumor in urinary tract, prostate problem or other conditions. Red urine should not be ignored and must be brought to a physician's notice immediately.
Blue or Green Urine
Asparagus and some medications can cause urine color appear green. Very few cases of blue urine have been reported but the causes of blue urine are same as those of green.
Medications: Amitripyiline, Azuresin, Bromoform, Chlorophyll containing breath mints, Cimetidine, Clioquinol, Flupirtine, Flutamide, Guaiacol, Indomethacin, Iodochlorhydroxyquin, Magnesium salicylate, Methocarbamol, Mitoxantone, Phenergan, Phenylbutazone, Phenyl salicylate, Promethazine, iv Propofol, Resorcinol Tetrahydronaphthalene, Thymol, Tolonium, Triamterene, Zaleplon.
Medical conditions: Familial hypercalcemia, bacterial infection caused by Pseudomonas, Hartnup's disease.
Meds with methylene blue dye in them will make urine appear green. Methylene blue dye has weak antiseptic properties. It is used in many medicines to reduce symptoms of urinary bladder inflammation or irritation. Other dyes such as diagnex, evan, indigo, methylene blue, toluedine blue may also make urine green.
Problem in the upper urinary tract may lead to tea colored or brown urine. This may be because of myoglobin or hemoglobin. Kidney infection, malaria, and drugs that can destruct the red blood cells can make urine appear brown or cola colored.
Medications such as the anti-malarial drugs chloroquine and hydroxychloroquine, furazolidone, levodopa, methocarbamol, methyldopa, metronidazole, nitrofurantoin, niridazole, primaquine. Overdose of acetaminophen/paracetamol can also cause brown urine.
Taking senna, rhubarb or fava beans in a lot of quantity can also make the urine brown.
Foods such as beets, blackberry, rhubarb, red clover, or beefsteak juice can bring about a pale pink color in the urine.
Medication propofol may also give urine a pinkish color.
Pigments from within our body like hemoglobin, melanin, porphyrin, or myoglobin are usually responsible for black discoloration of urine.
Iron given through muscular route and other medications like chloroquine, furazolidone, levodopa, metronidazole, and primaquine can give urine a dark appearance that is almost black.
Too much of fava beans and rhubarb may also give black appearance to the urine.
Poisons like cresol and endosulfan can also produce black urine by causing destruction of red blood cells and other cells. Paraphenylene dye present in hair dyes is one of the most common cause of black urine noted in patients who have taken the hairdye intentionally.
There is no such thing as purple urine. Purple urine is actually not the color of urine but the urine bag that was first used in a disease called purple urinary bag syndrome (PUBS) . This condition is caused by some bacteria that change the color of liver enzymes to blue and red pigments in the urine. These colors when react with the synthetic urine bag form purple color.
Constipation, long-term urinary catheterization, and high dietary levels of tryptophan can lead to purple urinary bags. Females, elderly people, and those with dehydration are at a higher risk of developing this PUBS.
Depending on the urine color, descriptions of four temperaments (choleric, melancholic, sanguineous, and phlegmatic) were given in the de Katham wheel in the 18th century. Pink, red, and green urine were linked with choleric personality. These are the people who are more extroverted, independent, decisive, and goal oriented. Blue color was associated with melancholic personality - analytical, detail oriented, deep thinker and introverts. Yellow was connected with sanguine personality, highly talkative, enthiastic, and social.
However, this theory is rejected by modern medical sciences. Though many advances have come in the urinalysis, knowing the possible causes of change in the urine color can help you in being alert.
If you have any questions about medications please feel free to ask me in the questions section below. I would be more than pleased to help you.
1. Viswanathan, S. (2013). Citation: Urine Bag as a Modern Day Matula. ISRN Nephrology. (12):109-116. Retrived on : December 9, 2018.
2. Singh, A.K. Agrawal, P. Singh, A.K. Singh O. (2014). Citation: Differentials of Abnormal Urine Color: a review. Annals of Applied Bio-sciences.(1):R21-25 Retrived on : December 11, 2018.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2018 Sherry Haynes
Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on April 09, 2019:
Hello, Sherry, as a child, I remember the color associated with urine in the fun fact game. But I had pleasure in reading the story for the information it impacts. Also, the article is educational. Now, I know what is happening as I urinate. Many thanks for sharing.
Sherry Haynes (author) on December 09, 2018:
Thanks for reading, Liz. Even I was amazed to see the case reports I read while researching this article.
Liz Westwood from UK on December 09, 2018:
I had heard of red urine from eating beetroot, but I had not seen such a comprehensive list as in this article.