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Dark urine What the urine color says
Dark urine can appear in very different facets and be colored from yellowish brown over dark orange and reddish brown up to deep brown or black. For the different hues and intensities different causes come into consideration. In some cases, the change in color is easily explained by, for example, a lack of fluid, as a result of which the urine appears in a highly concentrated form and is therefore colored brown.
The use of certain medications such as some antibiotics or agents for the tropical disease malaria are considered as a "harmless" cause. On the other hand, dark urine may also be associated, for example, with a disease of the liver (for example hepatitis, cirrhosis of the liver), the metabolic disorder porphyria or a disease of Meulengracht, as well as due to jaundice, e.g. due to a gallstone. In this case, for example, the bile pigment bilirubin can no longer be excreted via the intestine due to the occlusion of the bile duct, but is increasingly released via urine, whereby it typically assumes a dark, beer-brown color. According to the different possible causes, in dark colored urine should be consulted in any case immediately a doctor for clarification - especially if the discoloration continues after appropriate hydration.
contents
Definition urine
Causes of dark colored urine
dehydration
porphyria
Jaundice / jaundice
Morbus Meulengracht
Other causes
treatment
Naturopathy in dark urine
Definition urine
Urine - also called urine - is a liquid excretory product, which arises in the kidneys in the course of a complicated filtration and resorption process (diuresis) from the blood plasma. Subsequently, the urine passes through the ureter (ureter) into the bladder, from where it is finally delivered via the urethra ("micturition" or "urination"). Urination serves to regulate the fluid and electrolyte balance, but also to eliminate metabolic degradation products (urea, uric acid, for example) as well as remnants of drugs and toxins that are flushed out of the body together with the urine.
The urine consists mainly of water (95 percent), electrolytes and urea, added in varying proportions vitamins, organic acids such as citric acid, creatinine, uric acid, dyes and a very small proportion of proteins. Normally, urine is clear and slightly yellowish or amber, with the color being produced by urinary metabolites (urochromes). Accordingly, the emergence of the Urochrome decides on the expression of yellowing, which can vary from an intense yellow (hypotonic urine) to colorless or transparent very different. The "scent" of fresh urine is usually neutral, but the subsequent bacterial decomposition of excreted substances leads quite quickly to the typical pungent, ammonia-like odor.
Urine is generally considered to be an important indicator of various diseases, for example, blood in the urine may indicate renal pancreasing or renal infarction and a greater amount of uric acid may indicate diabetes mellitus. In addition, the color can also provide important information in the determination of diseases, because a dark or yellow coloration, for example, usually indicates a diseased liver.
Further help can be provided by the smell - a foul-smelling, stinking urine, for example, can be a clear sign of a metabolic disorder or certain bladder tumors. However, the smell can also be influenced by the diet, as it is typical after eating asparagus. This partially penetrating, cabbage-like odor is due to an enzyme that converts the aspartic acid contained in the asparagus into sulfur-containing substances - but this does not happen in all humans, because only about every second produces this enzyme.
Causes of dark colored urine
A temporarily dark urine is in many cases no cause for concern and often has "harmless" causes such as the use of certain drugs or active substances (for example, levodopa, methocarbamol, methyldopa or metronidazole) or the consumption of foods or drinks such as coffee which can discolor the urine from brownish to black. However, as a precaution, a doctor should always be consulted for clarification - especially if the urine is cloudy - because a dark color may also indicate more serious diseases such as liver cirrhosis or the metabolic disorder porphyria.
dehydration
A common, relatively "harmless" cause of discolored urine is a lack of fluid, because the body is almost 70 percent water and therefore needs much of it to function properly. On the one hand, this is important for transporting the absorbed nutrients into the individual cells for utilization, on the other hand, water is needed to drain metabolic waste products from the body - which happens primarily through the kidneys.
In addition, the body needs fluid to regulate body temperature, which provides some degree of temperature throughout the body - even in highly fluctuating ambient temperatures. If there is a deficiency, the body usually shows quite clearly about the thirst that "replenishment" is needed. This is usually due to a loss of water in the body of about 0.5%, the case, with a loss of about 10% it also causes a feeling of dryness in the mouth and speech problems.
In addition to the feeling of thirst, the body sends other alarm signals - often here are suddenly occurring headaches, which arise from the fact that the blood thickened by the lack of fluid and not enough oxygen can be passed on to the brain. Since most of the brain consists of water, it can also lead to shortage of concentration and attention, as well as to inner restlessness, nervousness and fatigue, in many cases dizziness occurs. The skin also suffers, because the water content in the body is too low, the remaining resources are first made available to the organs, because they need the water especially urgent, especially the liver, the intestine, the heart and the brain. As a result, the skin suffers from "withdrawal symptoms" and becomes dry, scaly and itchy, even chapped and brittle lips are a common sign of a lack of fluids.
In addition, but also suffers the digestive system, because due to insufficient fluid sinks the stool volume and it comes to a hard bowel movement, which is often difficult and laborious excrete. As a result, sufferers often have the feeling that the bowel is never completely deflated, in addition to other symptoms such as flatulence, nausea or abdominal pain that can develop to cramps.
Dark urine may be another signal here, because if it is drunk too little, the urine will not dilute, which will cause it not to be excreted in the "normal" pale yellow, but in concentrated dark colored form. This is in most cases no cause for concern and regulates relatively quickly, if provided with adequate replenishment - however, the urine remains dark despite adequate hydration, in any case, a doctor should be consulted to clarify the cause of this.
porphyria
Another cause of dark-colored urine may be a so-called "porphyria", which is a group of metabolic diseases characterized by a disturbed build-up of the red blood pigment heme, the iron-containing component of hemoglobin. The heme, which is responsible for oxygen binding and the red color of the blood as part of hemoglobin, is formed in eight steps, with one enzyme required for each step. If a porphyria is present, one of these enzymes is impaired in its function so that the biosynthesis of the heme can not be completed. As a result, more and more metabolic products (porphyrins) accumulate in the body - which exactly depends on which enzyme is defective, in some cases, several enzymes can be affected. The cause of a porphyria is in most cases an inherited genetic defect, whereby the disease often shows in this case already in childhood.
There is also the possibility that it lasts asymptomatically for a lifetime or initially remains undetected and only later in life by triggers such as certain drugs (for example, sulfa drugs, tranquilizers), birth control pills, smoking, stress, excessive alcohol consumption or increased hunger in the context of Diets or fasting typical disease signs are evoked. In addition, the disease can be acquired in rare cases, but also without genetic link (secondary porphyria) in the course of life, for example, as a result of poisoning with lead or certain pesticides or even a disorder of bilirubin transport (for example, rotor syndrome).
There are various forms of porphyria (for example, hereditary coproporphyria or erythropoietic protoporphyria), which are subdivided into "acute" and "cutaneous" porphyrias according to their respective symptoms - however, syndromes may overlap. Typical of the acute form is the sudden onset of massive abdominal pain that often lasts for days and nausea and vomiting, back pain, arm pain, leg pain, constipation, neurological deficits such as paralysis or nerve pain but also high blood pressure and psychiatric symptoms such as depressive moods, listlessness or a Psychosis can be accompanied.
For the cutaneous or skin-related porphyrias, on the other hand, a strong, very painful photosensitivity of the skin is characteristic, as a result of which, upon contact with sunlight, rapid itching, blisters on the skin and, later, scars occur. Depending on the porphyria form, serious damage to the skin and tissue or even the loss of parts of the body such as the nose, lips or finger parts can occur - in addition to severe pigmentation of the skin, increased body hair (hypertrichosis) or porphyrin deposits in the teeth (erythrodontia, In addition, the liver can be damaged by deposits of porphyrin up to cirrhosis of the liver.
In addition, as the defective metabolites of the red blood pigment are excreted by the kidneys, it can happen in both forms of the disease that the urine is dark colored or darkens after prolonged standing.
Jaundice / jaundice
If the urine is brown or even dark brown, jaundice is also considered, which is colloquially referred to as "jaundice". It is a yellowing of the skin, mucous membranes and dermis of the eyes (sclera), which is not a disease in itself, but a symptom of various diseases. Responsible for the yellowing is the yellow-brownish bile pigment "bilirubin", a degradation product of the red blood pigment hemoglobin, which in the course of various diseases of the liver, the biliary tract and the blood is in too high a concentration in the blood.
In jaundice, a liver disease is usually suspected, yet it can have a variety of causes and sometimes even not affect the liver. However, as the liver has a central role in bilirubin metabolism, there are three different types of jaundice medically, depending on where it exists. In a "prehepatic" (or "hemolytic") jaundice, therefore, a disorder "before" (composition of latin pre = before and hepar = liver) of the liver, showing itself by a premature or increased red blood cell disintegration (hemolysis) increasingly collects bilirubin in the blood, but the liver can no longer afford the breakdown of the dye. As a result, this deposits in the tissue and there is the typical yellowing of the skin and eyes.
In most cases, pre-hepatic jaundice is caused by blood disorders (such as "auricular cell anemia"), as well as various immune-related diseases, as well as, for example, malaria and poisoning. In this form of jaundice, it can also lead to fever, fatigue or nausea, stool and urine normally remain "normal" dark or bright, in extreme cases, the urine can also assume a red-brown color.
The second form of jaundice is called "hepatic jaundice", in which the bilirubin is no longer or only partially absorbed by the liver cells. The causes are found here directly in the liver, in many cases there is a hepatitis (liver inflammation), which can be triggered by viruses (eg hepatitis B), drugs (eg acetaminophen, certain antibiotics), various fungal toxins or toxic chemicals , even a pregnancy or the so-called "Epstein-Barr virus" come into consideration.
In most cases, however, heavy, excessive consumption of alcohol is responsible for liver inflammation, which can develop into severe cases, including cirrhosis of the liver or even liver cancer. In addition to the yellow skin and the yellow eyes, this form shows symptoms such as tiredness, nausea and vomiting as well as abdominal pain. The stool is usually normal or a little lighter colored, the urine, however, is a little darker.
The third form, "posthepatic jaundice" (or "cholestatic jaundice"), is a disorder that occurs only after the bilirubin has passed through the liver (post-hepatic = "after" the liver). The cause here is a blockage of the bile duct (cholestasis), whereby the bilirubin in the bile can not get into the intestine, but accumulates in the blood instead and leads to the typical yellowing. The increased bile acid often causes a strong, constant itching in this variant of jaundice, and a further sign is a pale bowel movement, which can almost turn white. This arises because the bilirubin no longer arrives in the intestine and consequently also the breakdown products (Sterkobilinogen) fail, which otherwise provide for the "normal" light to dark brown staining of the stool. While this becomes brighter, the urine turns dark brown ("beer brown"), because the outflow of the yellow-brown bile pigment through the bile is disturbed, it first accumulates in the blood and is finally excreted through the kidneys with the urine.
Gallbladder obstruction is often caused by gallstone, but can also cause tumors (for example, gallbladder cancer or liver cancer) as well as adhesions due to surgery or inflammation. Gallstones do not necessarily cause discomfort, so they are often discovered only by accident, for example, as part of an ultrasound examination or X-ray examination. In about one quarter of those affected, however, it comes to symptoms such as upper abdominal discomfort in the form of a pressure or fullness, frequent belching and flatulence - often especially after fatty food. In more severe cases, the stones can also cause greater problems, causing severe, colicky pain in the right middle and upper abdomen, which can radiate to some extent in the back or right shoulder area. Blocking the bile duct may also cause inflammation of the gallbladder or pancreas, which may be accompanied by severe pain, fever, and chills.
Morbus Meulengracht
In addition, the metabolic disorder Morbus Meulengracht (also Gilbert syndrome) may be the cause of dark urine, which affects about 5% of the population. Morbus Meulengracht is one of the so-called "familial Hyperbilirubinämiesyndromen", which are characterized by a disturbance of bilirubin metabolism. The cause is a congenital enzyme defect, through which the activity of the enzyme UDP-glucuronyltransferase reaches only about 30% of the "normal value". Because of this, the yellow-brown bilirubin can not be sufficiently reconstructed and excreted, which in most cases results in a slightly increased concentration of bile pigment in the blood.
Since this metabolic disorder does not lead to liver damage, it is usually not considered a "disease" in the strict sense - but can still lead to unpleasant symptoms and incompatibility of certain drugs (for example, in estrogen-containing hormones, buprenorphine, paracetamol or flavonoids).
In many cases, Meulengracht's disease is largely asymptomatic; however, as bilirubin levels rise, the symptoms of jaundice, such as yellow eyes, yellow skin and dark-colored urine, are common. These are usually relatively mild, but especially in connection with infections, alcohol consumption, stress or prolonged fasting and are often accompanied by discomfort, fatigue, difficulty concentrating, nausea, diarrhea and an unpleasant feeling in the liver.
Other causes
Another possible cause is a so-called "melanuria". This occurs in the context of a malignant melanoma or black skin cancer, which means a highly malignant tumor of the pigment cells (melanocytes), which tends to early metastasis spread over lymph and blood vessels and therefore represents the most frequently fatal skin disease. In this condition, the urine contains the body pigment melanogen, which oxidizes to melanin in the air and thereby turns the urine deep brown or even black.
Test strips can detect background diseases. Image: jarun011 - fotolia Even with a so-called "Alkaptonurie" may occur a dark brown or black urine. This is a very rare hereditary change in the tyrosine metabolism, which is caused by a defect or deficiency of the enzyme homogentisic acid dioxigenase. This leads to an accumulation of the degradation product homogentisic acid, which leads to a brown discoloration in the connective tissue of the skin and in the articular cartilage (ochronosis), in addition come gout-like arthritis, dark spots in the dermis of the eye and an increased risk of kidney stones and Damage to the heart valves or aorta. Since the homogentisic acid produced in alkaptonuria in alkaline liquids and in the air forms a dark brown-black dye, a dark color of the urine occurs only when it is longer or alkaline - for example, after carbohydrate-rich diet.
Although there is currently no treatment method by which the disease can be completely cured, there are still some therapeutic options, such as the reduction of the formation of dye formation by high doses of ascorbic acid (vitamin C) in combination with a phenylalanine-tyrosine poor diet ( little meat, sausage, fish, cheese, eggs and milk-containing sweets).
In equally rare cases, the so-called "blackwater fever" (English "blackwater fever") comes into consideration. This is a complication of malaria, often triggered by the use of the active ingredients quinine or antipyrine. In this disease, an acute decay of red blood cells (hemolysis) causes the blood pigment (hemoglobin) to be excreted in the urine (hemoglobinuria). Accordingly, the typical symptom is a deep dark to black-red colored urine, in addition to severe fatigue, bilious, partially unstable vomiting, headache, anxiety and jaundice and the degeneration of the kidneys, liver and heart. Since the mortality in black water fever is relatively high, especially a quick medical care is important here, however, is not intensive medical treatment, occurs mostly within a short time by the failure of the kidneys death.
treatment
Therapy for dehydration
If a lack of fluid is the cause of dark urine, the most important thing is to drink water, unsweetened tea, or juice spritzer to restore balance.
If stubborn bowel movements or constipation occur in the course of the deficiency, then sufficient movement and a high-fiber diet (for example with whole grains, lentils, beans, fruits and vegetables) should be taken in parallel with drinking in order to stimulate or normalize the intestinal activity , If this does not help, hard bowel movements can also be treated with medication - as a rule, the active substance "lactulose" is used as a laxative, which makes the stool softer again and thus simplifies defecation. However, it often leads to side effects such as bloating, moreover, this form of therapy, for example, for people with a congenital intolerance to galactose is not suitable. Accordingly, self-medication with laxatives is strongly discouraged; instead, treatment with lactulose should only take place under medical supervision.
Concentration problems, severe tiredness or dizziness can occur as a result of a lack of fluids, and the consumption of a banana can work wonders in parallel with drinking, as it quickly gives the body new energy through an optimal combination of vitamins, minerals, carbohydrates and protein. Nuts are also wonderfully nourishing as they contain a high amount of trace elements (such as iron, zinc and sulfur), minerals and B vitamins as well as amino acids, unsaturated fatty acids, vitamin E and vegetable protein, which provides the brain with energy and energy the concentration or performance is promoted particularly strong.
Basically, do not wait until the body indicates with the signal "Thirst" that fluid is missing, as there is already a certain deficit at this time. Instead, it is advisable to drink repeatedly throughout the day so that the body remains well-cared for, healthy and capable throughout. However, those who often forget to drink can help themselves by, for example, being reminded by an alarm clock to drink a glass of water every hour, which makes it sensibly possible to prevent headaches, dizziness and irregular digestion. Especially for older people, it is very important to think about regular drinking, because the feeling of thirst decreases with age and it can thus quickly lead to a lack of fluids.
Treatment for porphyria
If the dark urine is due to a porphyria, the therapy depends on which form of the disease is present. Since this is genetically determined in most cases, it can not be completely cured here - instead, the therapy of the respective symptoms is in the foreground. In the case of acute porphyria, it is advisable to consistently refrain from alcohol and smoking as well as starvation due to irregular eating in order to minimize the risk of a relapse. If medications are needed or if medication changes, a porphyria expert should also be consulted to avoid taking any relapsing medications (such as barbiturates, diazepam, phenytoin, or theophylline). In addition, it is possible to treat an acute stroke with high carbohydrate levels or hemin via infusion.
Since cutaneous porphyria is not a causal therapy, it is usually attempted to reduce porphyrins in the body in order to alleviate the signs of the disease. Since this form of disease is a massive sensitivity to (sun) light, this should be avoided as much as possible, as well as liver-damaging substances (alcohol, medicines, etc.)..
Treatment for jaundice
In the case of jaundice, the treatment is first according to the underlying disease. If, for example, the bile can not drain due to barriers, the bile ducts are freed of gallstones or tumors during endoscopic surgery. Subsequently, small tubes of plastic or metal (stents) are inserted into the bile duct to keep it wide and to ensure the drainage of the jammed bile. In the case of hepatitis, various therapeutic measures may be considered. For example, in the case of acute viral hepatitis, bed rest and prohibition of alcohol are the main focus, whereas chronic hepatitis B often uses antiviral substances such as lamivudine and tenofovir. Chronic hepatitis C is generally treated with a combination of pegylated interferon-alpha (PEG-IFN) and ribavirin.
In addition to these measures, sufferers should refrain from any alcohol at the first sign of liver inflammation and to find out which drugs could have harmful effects on the liver. In addition, more attention should be paid to a balanced diet and acute inflammation to ensure sufficient peace in an infection with the virus type B or C, it is also important to inform family members and sexual partners in order to avoid infection.
Therapy for Morbus Meulengracht
There is no therapy for this metabolic disorder, as the defective enzyme UDP-glucuronyltransferase can neither be repaired nor compensated. However, this is usually not a problem, because the "disease" causes in most cases no or only very slight symptoms and does not limit the life expectancy of the person in any way. Accordingly, the only option is to adjust your own habits so far that the disease does not cause major problems. This includes, in particular, the avoidance of alcohol, smoking, stress, prolonged starvation or fasting and irregular sleep, but also the best possible protection against infections, because even such can lead to an increase in bilirubin.
Naturopathy in dark urine
In order to prevent darkening naturally, care should be taken at all times to drink at all times, because in the case of a lack of fluid, the urine is not diluted, but rather concentrated, and therefore darker than normal. This can also be promoted by heavy sweating (for example, in sports), so it is also particularly important to quickly replenish the fluid balance of the body.
Likewise, however, a serious disease of the liver may be present - therefore, a medical clarification or care in conspicuous dark urine in any case necessary. At the same time, however, the field of naturopathy also offers various opportunities to strengthen the health of the largest organ in the human body and thereby prevent symptoms and symptoms such as the darkening of the urine. For example, the dandelion is considered a true "miracle plant" for the health of the liver, as it has a choleretic effect by stimulating bile production in the liver, causing the excretion of a low-viscosity bile and thus improves the lipid metabolism. For this reason, the herb is very much used as a medicinal plant for jaundice, gallstones or liver cirrhosis - which, of course, may only happen in coordination with an experienced naturopath or doctor to avoid further damage to health.
Dandelion is often used as tea or press juice from fresh plants, in addition to the leaves can also be enjoyed in the form of vegetables, soup or smoothies. In view of the upcoming summer, dandelion lettuce is a delicious and extremely healthy alternative to other lettuce, because dandelion contains about nine times as much vitamin C as lettuce, in addition to its liver-strengthening ingredients. For this purpose, 400gr dandelions are washed for four persons, tumbled dry and cut into strips on plates.
In the next step, a leek onion is cleaned and cut into fine rings and halved about 12 black olives and then added to the dandelion. The salad is finally refined with 200gr of sheep's cheese in small cubes, a tablespoon of pine nuts and, if necessary, minced garlic. For the dressing, finally 4 tablespoons of olive oil with 3 tablespoons of mild herbal vinegar, a tablespoon of mustard, salt and black pepper from the mill well mixed and just before serving over the salad.
Also very useful for the health of the liver is from a naturopathic perspective, a regular detoxification to dissipate for the body polluting accumulated toxins or to metabolize. Who wants to detoxify his liver, can fall back on different measures such as Glauber's salt. It is sodium sulphate (Natrium sulphuricum), which is taken on two consecutive days together with grapefruit juice and olive oil and acts in this way as a natural laxative. This form of treatment should, however, due to partially severe vomiting and massive diarrhea on the one hand only after consultation with a doctor or naturopath and on the other hand in the best case be carried out at the weekend, so that the body can recover sufficiently the next day.
It is easier to support the health of the liver with Schüssler salts. In particular, the Schüssler salt No. 6 (potassium sulfuricum), which stimulates the liver and thus the detoxification and boosts the fat metabolism, and the salt no. 10, which also stimulates and in this way the excretion of toxins from the Body supported. Again, before taking a dose should always be consulted with the doctor or alternative practitioner to match the ideal dosage and potency. (No)