Dark urine

Urine colour reflects how concentrated it is and what is dissolved in it. Dark urine is most commonly just concentrated urine from not drinking enough, and it lightens quickly with more fluids — a harmless everyday cause. Some foods (beetroot, blackberries) and medicines or vitamins can also colour urine, without being a problem. But persistently dark or brown urine can point to something that needs attention. A brown or tea-colour, especially with pale stools and yellow skin (jaundice), suggests a liver or bile-duct problem (such as hepatitis or a blocked bile duct), where bilirubin spills into the urine. Red, pink or cola-coloured urine can mean blood (from an infection, stone, or other cause) or, when accompanied by jaundice, the breakdown of red blood cells (haemolysis). Cola-coloured urine with severe muscle pain can indicate serious muscle breakdown (rhabdomyolysis), which threatens the kidneys. So the key is whether dark urine clears with hydration or persists — and what other symptoms come with it.

• Dehydration — the commonest cause; concentrated urine that lightens with fluids.
• Foods and medicines — beetroot, blackberries, some vitamins and drugs; harmless.
• Liver or bile-duct problems — brown/tea-coloured urine with pale stools and jaundice (hepatitis, blocked bile duct).
• Blood in the urine — from infection, stones, kidney disease, or other causes.
• Haemolysis — red-cell breakdown, often with jaundice.
• Rhabdomyolysis — cola-coloured urine with severe muscle pain; a serious cause.

The first step is a urine test to see what is causing the colour — whether it contains bilirubin (pointing to the liver or bile ducts), blood, or muscle pigment (myoglobin). Depending on that, blood tests help: liver function (bilirubin, ALT) for a liver or bile cause, the haemolysis markers (haptoglobin, LDH, bilirubin, reticulocytes) if red cells are breaking down, and creatine kinase and kidney function if muscle breakdown is suspected. Mediora.AI can surface a liver or haemolysis pattern from your results that fits the colour change, but dark urine that persists despite good hydration, or comes with jaundice, pain or feeling unwell, needs assessment by your doctor with a urine test.