What the colour of your urine says about your health

You do it several times a day, but do you ever stop and take a look at the colour of your urine? 

While
most rarely give it a second thought, the colour of your urine can tell
you so much about the state of your health. The various colours of your
urine indicate everything from dehydration to disease, so making the
most of that routine trip to the toilet could save your life. 

We
flushed out an expert on the subject, urological surgeon Dr. Howard
Evans of the Alberta Urology Institute and the University of Alberta’s
Division of Urology, to break down the lighter and darker shades of
pale, and what they mean.

 Crystal Clear

You
might think transparency is a good thing, and it is. Mostly. Dr. Evans
says clear urine can also be a sign you’re taking in too many fluids,
and that’s not good. 

“If
your urine is really clear, as clear as water, you may be
over-hydrated,” he says. “But it’s rare to over-hydrate. We all err on
the side of under-hydration.” In fact, he says many people who
over-hydrate are obsessed, and that can be dangerous. 

“The
risk is that your sodium level, which needs to stay at a nice solid
level in your body, can drop, and if it drops too low it can be
critical. Your kidneys work to maintain a certain level, but if you
present them with too much water they start spilling electrolytes out,
sodium being one of them.” 

So
what’s too much? Four or five litres a day, says the good doctor, but
you really have to be guzzling non-stop to consume that much. 

Straw or Pale Yellow

This is the holy grail of output — a mellow yellow that tells you all is good. 

Urine
is made up of water, urea, sodium chloride, potassium chloride,
phosphates, uric acid, organic salts and a bile derivative called
urobilin, which gives pee its normal yellow colour. When all those
elements are in balance, so are you. 

Urine
will be naturally darker and more concentrated first thing in the
morning, since most people generally don’t drink in their sleep, but
should lighten up as the day goes on and fluid intake goes up. 

Brownish-Orange

If your urine is dark to the point of brown, you’re dehydrated – but this has a quick fix. 

If
you’ve been over-indulging in rhubarb or fava beans, however, those
could be the culprits, in which case that’s another quick fix. 

Similarly
with orange urine: you’re dehydrated or have ingested food dye. Also,
some vitamins, such as B-complex and C, can turn urine a deep, sometimes
fluorescent, yellow. 

If
none of these applies, and if re-hydration doesn’t clear it up, you
could have liver or bile duct troubles, particularly if you have
associated factors such as pale stools and yellow eyes and skin, in
which case a trip to the doc is highly recommended. 

Pinkish-Red

Unless you’ve chowed down on a ton of beets or berries, you don’t want to see red in the toilet. 

That’s
most certainly blood, an indication of a host of potential problems,
from benign to malignant. Urinary tract infection, kidney or bladder
stones, kidney disease and the more serious kidney, bladder or prostate
cancers are some of the possibilities, particularly if the bleeding is
painless, a signal something more serious is afoot. 

“A
little light red you want to be looked at, but if you’re seeing
particulate matter, you should get in quite quickly,” says Dr. Evans. 

Long-distance runners and extreme exercisers can also get pinky-red urine due to muscle breakdown, he says, but that’s unusual. 

Blue or Green

If
red urine sets off alarm bells, imagine seeing blue or green splashing
around the toilet bowl. Fortunately, this is as rare as a leprechaun in
spring, although it can indicate a little-known inherited enzyme disease
called porphyria. 

Usually
it’s simply a sign of what you’ve swallowed, such as certain
medications or food dyes that don’t get absorbed and pass out through
the GI tract. 

“If
your kids have been eating blue-frosted cupcakes at a birthday party,
or you’ve been drinking green beer at a St. Patrick’s Day party, that’s
usually your answer,” says Dr. Evans. 

If none of these applies, however, “go see someone because you might have something weird going on,” he says. 

White, Cloudy

Most people immediately suspect infection when their pee turns cloudy, but that’s not the whole story. 

“The
most common reason is you have phosphates in your urine,” says Dr.
Evans, which is harmless if you’re not having associated symptoms such
as pain, blood or constant urination. 

“It
sometimes can point to kidney problems, [meaning] you’re spilling
phosphates from your kidneys which would normally go back into your
bloodstream. Otherwise, if you have cloudy urine and you drink some
extra water and it goes away, that’s a benign thing; you’ve got some
phosphates in there or some other element that’s making your urine
cloudy.” 

Froth and Foam

Usually
caused by the strength of your stream, foamy urine can also indicate
protein in your pee, which can be a sign of kidney trouble. 

“A
foamy, frothy top to the urine can be a sign of a lot of protein, most
common in people with kidney disease,” says Dr. Evans. 

“Generally
speaking, you shouldn’t have any protein in your urine because your
kidneys filter it out. But if the pores in your kidney filter get
thicker then the bigger proteins can get through and that’s when you get
the problems.”

If excess bubbles aren’t the result of a fire-hose flow, see a doctor.

Scent of a Veggie

Smelly
pee is not usually a sign anything is amiss, it’s more likely an
indicator of medications you’re taking or foods you’ve eaten. 

“The
classic ‘asparagus urine’ is a genetic condition,” says Dr. Evans.
“There are some people who have a gene that if they eat asparagus, the
first urination afterwards smells very odd. Also, more concentrated
urine will have a stronger smell. Most infected urine, however, doesn’t
smell that bad.”

Bottom Line 

“If
you see a change in the colour of your urine, drink more water for the
next couple of hours and see what happens,” says Dr. Evans. “If things
get much better, you have your answer; you were probably just a little
dehydrated.” 

He
says normal output is about two litres a day (four or five trips to the
loo), because you should be taking in two litres of fluid a day. And
that fluid should, ideally, be plain old tap water, he says. 

“We’re
made of 65 per cent water; that’s something we need to [maintain]. If
water is not palatable enough for you, throw a bit of lemon juice in it.
But water truly is the best thing because that’s what’s keeping you
healthy. When you’re properly hydrated you’re going to feel better, look
better, your skin will be better, you’ll have more energy, you’ll be
more alert. In this day and age when people are looking for the next
quick fix, guess what? Just turn the tap on, have a glass of water.”

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Are you an alcoholic - It is not as obvious as you might think

Chances
are you raised a glass of something bubbly during a toast to a Happy
New Year. Chances are you followed that toast with a resolution to make
the year ahead better than the one before. And chances are one of those
vows included cutting back — or out — on the very cheer you used to ring
in a happier, healthier future. Why? Maybe because you’ve spent one too
many nights praying to the porcelain god, one too many mornings
wondering what you did the night before, one more wasted day nursing a
wicked hangover. Maybe it’s because you’re afraid. Afraid you’re
becoming — gulp — an alcoholic. But how can you know for sure? 

Signs and signals 

Dr. Jurgen Rehm, PhD, Director of the Social and Epidemiological Research Department at Toronto’s Centre For Addiction and Mental Health (CAMH), says there are a number of psychological signs of “alcohol
dependence,” a term he prefers over “alcoholic.” These include
preoccupation with the thought of drinking, drinking alone or in secret,
drinking despite knowing the risks and harm. Withdrawal and tolerance
are two of the most important biological criteria. Tolerance is defined
as needing more and more alcohol to satisfy the craving; withdrawal
includes symptoms such as tremors, restlessness and agitation. If you
recognize yourself in any of those symptoms, you could have a problem. 

The
archetype of the bum slumped curbside cradling a bottle inside a brown
paper bag is just one, albeit uncommon, example of an alcoholic. The
other is of a perfectly ordinary person who consumes copious amounts of
booze with seemingly no effect. “The majority of people who are alcohol
dependent in our society are what you would call functional alcoholics,”
Rehm explains. “You would be surprised to learn how many qualify.” 

Sobering stats 

According to
Health Canada, 4 to 5 million of us engage in high-risk drinking. Other
studies estimate 10 per cent of us use alcohol to the extent that it’s a
hazard to our health or relationships, and disrupts work and school. In
fact, Canadians drink a staggering one-and-a-half times the global
average, Rehn confirms. Since more than half the worldwide adult
population abstains from alcohol completely over their lifetime, we’re
obviously working hard to keep the numbers up. And, says Rehm, “A lot of
people from those populations are immigrating to Canada. So if we have
the same level of drinking, that means the drinkers drink more per
drinker because the immigrants are most often abstainers.” 

So
why are we knocking back so much booze, anyway? It’s expensive. It’s
bad for our health. It ruins our sleep and hurts our relationships.
Hangovers are hell. What gives? 

A
lot of us reach for the bottle as a way to cope with stress and
anxiety. It is, in fact, the most common way we self-medicate for
depression. But it so often backfires, because alcohol is a temporary
salve. Once we’re sober, the problems are still there. So we pour
another, and the cycle continues. It’s not a particularly viable coping
strategy, since it doesn’t get at the core of what’s causing the
depression or anxiety. Yet you’d be forgiven for thinking drinkers are
perennially happy and carefree: the cocktail culture is omnipresent in
marketing and advertising, TV and movies, where imbibing is depicted as
not only socially acceptable but often encouraged and rewarded. 

But
while we’re helping boost the bottom lines of the big booze companies,
our bodies are breaking down under the toxic effects of too much
alcohol. Alcohol affects brain function, including memory, focus, mood
and behaviour. It harms the heart, the liver and the pancreas and
increases your risk of cancer. In fact, Rehm outright calls alcohol a
carcinogen. Worse, it’s a factor in 7 per cent of all deaths in Canada.
Not to mention a burden on the public health system, as well as on
friends and families. 

How much is too much? 

Canada’s Low-Risk Alcohol Drinking Guidelines
stipulate a maximum of 10 drinks per week for women, 15 for men (a
drink is defined as 12 ounces of beer/cider/cooler, five ounces of wine,
or one-and-a-half ounces of liquor), with no more than two a day, and
with a couple of drink-free days a week. Pregnant women, anyone on
certain medications or with a family history of alcohol abuse, of
course, should abstain completely. 

Rehm
acknowledges the research that some moderate drinking — one a day or
one every other day — can be beneficial, since it raises good
cholesterol, which lowers the risk of coronary heart disease. 

“If
you religiously drink just one a day, I don’t think health would be a
big concern,” he says. “Unfortunately, less than 1 per cent of Canadians
would drink only one a day, so it’s very rare that people would
actually drink in a way that would be beneficial to their health.” 

In
fact, some experts say alcohol-associated health risks outweigh any
benefits. And if you’ve never been a drinker, there’s no reason to start
based on any perceived advantages. Exercise and a healthy diet are, as
always, far better options for thwarting illness and disease. 

How to quit

Even
if you’re the slightest bit concerned you’re drinking too much, you
might want to put a cork in it now. After all, New Year’s resolutions
don’t come out of the blue. Chances are you’ve been mulling the idea
long before the clock struck midnight on Jan. 1.

Quitting
isn’t easy. You’ll have to face some hard truths; you may feel guilt,
shame, weak. But admitting you have a problem truly is the first,
perhaps hardest, step. The rest will range from difficult to hell, and
will determine whether you go it alone or seek help. 

“If
there is a manifest dependence or problem, it would be good to consult a
specialist,” says Rehm, “and there are a lot of therapies that don’t
require that you go overnight or quit your job.” 

The
important thing is that you do something. Rehm notes that just one out
of 10 problem drinkers in Ontario goes into treatment, because it’s so
stigmatized. “It’s the lowest of any chronic disease. With diabetes,
nine out of 10 get treatment.” But yet both conditions can be
self-inflicted. 

“We
don’t stigmatize someone who has blood pressure over 140, but where do
you think high blood pressure comes from? Surely not from eating
correctly or having enough exercise.” 

So
what does modern detox look like? Rehm says a combination of
psychotherapy, motivational enhancement therapy and cognitive
behavioural therapy will likely be suggested in order to identify why
you drink and teach you how to avoid triggers. Anti-alcohol drugs might
also be a part of the treatment to block the effects of alcohol and/or
ease withdrawal. 

For
mild or moderate dependence, urges and cravings are often short-lived
and controllable. If you can distract yourself long enough for them to
pass, you’re ahead of the game. Adopt the “recognize-avoid-cope”
approach used in cognitive behavioural therapy to change harmful
patterns: Recognize your triggers; avoid tempting situations; employ
coping mechanisms when the first two fail. While you wait for the urge
to pass, try meditating, calling someone, going for a walk, diving into a
hobby, taking a bath, having a bowl of ice cream or cup of tea. Remind
yourself why you’re making this change, and applaud yourself for it. 

Before
you know it, the hankering will fade and you truly will have a happy
(and healthy) new year. And that’s something to celebrate.