Liquid Gold
Andrew Siegel, MD Blog # 95
Urine is as valuable as gold is—at least when it comes to its potential for revealing our underlying health or infirmity. Our kidneys work 24/7/365 filtering and removing from our bloodstream toxic wastes. These include nitrogen-rich soluble products generated from cellular metabolism, numerous other organic and inorganic chemicals, salts and metabolites, as well as excessive water. Urine—the end product appearing in our bladders—can provide amazing insight into our overall health.
With every pulsation of our heart, arterial blood flows into the kidney via the renal arteries; after the blood is filtered, the cleansed blood is returned via the renal veins. In essence, the artery brings “dirty” blood to the kidneys for filtering, with the renal veins providing transport back of cleansed blood. Urine is a sterile by-product of this filtering process. For this reason, when operating on the urinary tract (for example when the bladder is opened and urine enters the abdominal cavity), it is of no concern from an infectious point of view.
Using a simple and inexpensive dipstick, in a matter of moments, diabetes, kidney disease, urinary tract infection and the presence of blood in the urine can be diagnosed. Although there are many benign causes of blood in the urine, the worrisome possibilities are kidney and bladder cancer. The dipstick also reveals specific gravity, a test that can indicate dehydration, over-hydration, and other potential health issues. Not only can the dipstick disclose the presence of diabetes mellitus (sugar diabetes), but it can also reveal a condition known as diabetes insipidus, in which the kidneys lose their ability to concentrate urine. As a result, massive amounts of dilute urine are produced, which can have dire consequences. Urine testing can also reveal substance and performance-enhancing drug abuse. Who knew that a waste product could be so revealing? Of all the waste products that humans produce, urine uniquely provides the best “tell” regarding our health.
Urine odor can provide information as well. A sweet smell is consistent with diabetes mellitus; a foul odor may indicate a urinary infection or the intake of certain foods such as asparagus. Vitamin intake can also cause the urine to have an unpleasant odor. Vitamins B and C are water soluble and therefore not stored in the body. Any excess above what is necessary for the body’s use is immediately excreted in the urine. Malodorous urine that has a feculent scent may indicate an abnormal connection between the colon and the bladder that is known as a colo-vesical fistula. This happens most commonly on the basis of diverticular disease of the colon. When it occurs, there is often air in the urine, designated by the term pneumaturia.
Color is a “tell” with respect to hydration status. When well hydrated, our urine will look clear or very pale yellow, like a light American beer. When dehydrated, our urine becomes very concentrated, appearing dark amber, like a strong German beer. Excessive B vitamins can result in light orange urine. Red urine is most often blood in the urine, which may indicate a potentially serious underlying condition, although overconsumption of beets, blackberries, and rhubarb may sometimes impart a red color to urine. “Iced tea” or “cola” colored urine is often indicative of old blood, as opposed to the bright red color of urine indicative of fresh and active bleeding. Dark brown urine may indicate jaundice. Pyridium, prescribed for the discomfort of urinary infections, turns the urine a neon orange color. Other urinary analgesics that contain methylene blue can turn the urine blue or green. Cloudy urine may be indicative of a urinary tract infection, but can also occur when phosphate salts crystallize in the urine on the basis of dietary intake of foods high in phophates.
When our urine is occasionally foamy or sudsy, it is considered to be normal. When it occurs consistently, it can be a sign of protein in the urine, indicative of kidney disease.
Bottom Line: Urine is an invaluable waste product and offers many clues as to our overall health or presence of illness.
What a dipstick can reveal:
specific gravity…status of our hydration
pH…acidity of urine
leukocytes…urinary infection
blood…many urological disorders including kidney and bladder cancer
nitrite…urinary infection
ketones…in the absence of carbohydrate intake, fat is used as fuel and ketones are by-products of fat metabolism; may also indicate a very serious condition known as diabetic ketoacidosis
bilirubin…a yellow pigment found in bile, a substance made by the liver; its presence may be indicative of jaundice
urobilinogen…a byproduct of bilirubin breakdown formed in the intestines by bacteria—when elevated may indicate: impaired liver function; hepatitis; cirrhosis; excessive breakdown of red blood cells—when low may indicate bile obstruction or failure of bile production
protein…kidney disease
glucose…diabetes
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Andrew Siegel, M.D.
Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food: www.promiscuouseating.com
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