When Urine Isn’t Yellow: A Color-Coded Guide to Causes

If you see an unexpected shade of urine in your toilet, thank your urochrome.

Urochrome – a waste product derived from the breakdown of hemoglobin – is specific to the pigment of urine. Consider it the “red alert” of urologic function; unassuming when all is well, but a real whistle-blower if something isn’t right – such as when the pee stream turns from a normal pale yellow to red, brown, blue, or green.

The culprits can be as simple as diet, exercise, or medications. However, off-color urine also may indicate a serious health issue. Following is a light-to-dark color guide of how urine leaves the body, and why.

Peeing a Kaleidoscope: Causes by Color

Normal urine comes out pale yellow to gold, the intensity of color reflecting factors such as how well hydrated one is, diet, vitamins taken, and even the amount of exercise one gets. The more concentrated the urine, the darker it becomes. Honey-colored urine, for example, may signal dehydration. Bright yellow pee could be due to high doses of vitamin B.

But the pee palette can be surprisingly broad, reflecting a range of other behavioral or medical issues.

• Pink or red. Foods such as beets and blackberries, as well as medications, could make urine take on a rosy hue. If these factors are ruled out, then it may be hematuria, or blood in the urine. A range of health issues can cause this, including urinary tract infections, an enlarged prostate, and bladder or kidney stones. Even extreme exercise can cause hematuria, if it results in muscle damage, which some call “runner’s bladder.”
• Orange to light brown. High amounts of blood in the urine can turn it dark orange to brown. This too is a common sign of a urinary tract infection, but it also could indicate bleeding from the bladder – a symptom of bladder cancer. Some medications, including anti-inflammatories and some laxatives, may cause urine to take on a reddish-orange tint.
• Dark brown. If the pee stream looks like a cola stream, it may be due to certain foods, including fava beans and rhubarb, as well as medications like antibiotics, laxatives, and muscle relaxants. But medically, dark brown urine could be an alert that the liver or kidneys are malfunctioning – particularly if the patient also has pale stools and yellowing skin and eyes. Brown urine can be a common sign of hepatitis or severe dehydration.
• Blue or green. Yes, it happens. Often, food dyes may cause urine to turn green, while the dyes a physician will use to test kidney or bladder function will come out blue. Other causes include pain treatment or anti-depressant medications (green or blue), urinary tract infections (green), or a rare inherited disorder that occurs in children called “blue diaper syndrome.”

When Your Urochrome Is a Red Flag

Don’t mistake a red flag for a pink one. While tinted urine might not be an emergency issue, there are cases when one should see a doctor immediately.

If you or a loved one notices a change in urochrome that is severe, chronic, or not explained by diet or medications, call your urologist. Urine tests are fast, easy, and pain-free.

To read more about urinary health, click here.