Dark Brown Urine Symptoms, Causes & Common Questions

Dark brown urine can be caused by hydration, dietary changes, or side effects from supplements or medication. Other dark urine causes include sexually transmitted infections or kidney disease. Read below for more information on causes and treatments.

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Contents

  1. Symptoms
  2. Causes
  3. 10 Possible Dark Brown Urine Conditions
  4. Treatments and Relief
  5. Questions Your Doctor May Ask
  6. Statistics
  7. Related Articles
  8. References

Dark Brown Urine Symptoms

The body eliminates excess water and waste through urine. Urine is typically yellow in color, and depending on the amount of water in the urine, this yellow color can range from pale (diluted), to deep gold or amber (concentrated) [1,2].

Even with this broad range of normal colors, many different processes can change the color of urine from yellow to dark brown or even pink or maroon. Most of these processes are benign, but processes that produce dark brown urine are usually a sign of an underlying problem and should always be followed up with your doctor.

Other accompanying symptoms of dark urine

If you notice dark brown urine, take note of other symptoms you may be experiencing, such as:

Make an appointment with your doctor as soon as you notice any of these dark brown urine symptoms to get appropriate care.

Dark Brown Urine Causes

The process of urination requires multiple parts of the body — the kidneys filter the urine, the ureters carry urine from the kidney to the bladder where urine is stored, and finally the urethra takes urine from the bladder and expels it from the body. All of these are parts of the urinary tract.

Anything that your kidney filters and excretes via the urinary tract can affect the color of the urine. Urine can change color depending on the amount of water your body excretes, pigments present in food, and systemic processes that cause bodily breakdown [3,4].

Medical conditions

Certain medical conditions or illnesses can lead to dark brown urine.

  • Infection: Many types of outside bacteria can easily enter the body via the urinary tract, including sexually transmitted bacteria such as gonorrhea and chlamydia. Urinary tract infections often cause dark brown urine symptoms in addition to pain [5].
  • Blood disorders: Conditions that cause breakdown and destruction of blood cells can turn urine dark brown. Any blood disorder that involves breakdown of hemoglobin — a component of red blood cells — will be excreted by the kidneys turning the urine dark brown [6].
  • Systemic disease: Diseases that affect the kidney and liver can seriously affect the processes that filter and excrete urine. Such conditions can include cancer, hepatitis, and cirrhosis.

Medication

Medication-related causes of dark brown urine may be related to the following.

  • Antibiotics: Certain antibiotics such as metronidazole often turn the urine dark brown. The change in color is usually benign and due to pigment in the medications that are filtered out into the urine.
  • Antimalarial: Drugs such as chloroquine and primaquine can also turn urine dark brown.

Environmental causes

Environmental causes of dark brown urine may be related to lifestyle habits or certain exposures.

  • Diet: Eating large amounts of fava beans, rhubarb, and or aloe can cause dark brown urine [7]. The mechanisms are not clearly known. Furthermore, severe dehydration and insufficient water intake can also turn urine dark brown.
  • Exercise: Overly strenuous exercise can cause serious breakdown and damage of muscle cells. This breakdown of muscle releases toxic products (myoglobin) into the bloodstream that are filtered and excreted by the kidneys. These breakdown products turn the urine dark brown and injure the kidneys [8]. This is a serious illness needing immediate medical attention.

10 Possible Dark Brown Urine Conditions

The list below shows results from the use of our quiz by Buoy users who experienced dark brown urine. This list does not constitute medical advice and may not accurately represent what you have.

Dehydration

Dehydration means the body does not have enough water to carry out its normal processes.

Most susceptible to serious dehydration are young children with fever, vomiting, and diarrhea. In adults, some medications increase urination and can lead to dehydration. Anyone exercising vigorously, especially in hot weather, can quickly become dehydrated.

Symptoms include extreme thirst; dry mouth; infrequent, dark-colored urine; dizziness; and confusion. Young children may have sunken eyes, cheeks, and soft spot on top of the skull.

Severe dehydration is a serious medical emergency that can lead to heat stroke, kidney damage, seizures, coma, and death. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through blood tests and urine tests.

Mild dehydration can be treated simply by drinking extra water, or water with electrolytes such as sports drinks. More serious cases may be hospitalized for intravenous fluids.

It's important for anyone who is outside in hot weather, or who is ill, to drink extra fluids even before feeling thirsty as thirst is not always a reliable guide.

Rarity: Rare

Top Symptoms: fatigue, dizziness, vomiting or diarrhea, racing heart beat, being severely ill

Urgency: Hospital emergency room

Non-specific change in urine

Urine is the product of the kidneys filtering the blood from waste products and excess water. Depending on what you eat, the color and odor of your urine can change. Beets are known to turn urine pink or red, which can be mistaken for blood. Asparagus sometimes gives a distinctive smell. Medication can also change smell and color of your urine.

Rarity: Common

Top Symptoms: a change in either color of odor of urine, frequent urination

Symptoms that always occur with non-specific change in urine: a change in either color of odor of urine

Symptoms that never occur with non-specific change in urine: painful urination, bright red (bloody) urine, fever, frequent urination

Urgency: Wait and watch

Chronic hepatitis c

Chronic hepatitis C is a liver inflammation caused by Hepacivirus C.

If someone is infected with hepatitis C and gets the acute form of the disease, there is about a 50% chance of the disease becoming chronic. This means that the virus remains in the body after the acute, short-term disease is over, and may or may not cause further illness.

Some patients have no symptoms of chronic hepatitis C until years later, when liver damage has developed and the signs of cirrhosis (scarring) begin to appear. Hepatitis C can also lead to liver cancer.

Diagnosis is made through blood tests.

Treatment for chronic hepatitis C involves taking medications prescribed by the physician; avoiding alcohol; and using no supplements or prescription medications without a doctor's clearance. In some cases, a liver transplant will be needed to save the patient's life.

The best prevention is to never share needles, toothbrushes, or other personal care items, and to always practice safe sex. There is no vaccine for hepatitis C.

Rarity: Common

Top Symptoms: fatigue, nausea, muscle aches, loss of appetite, joint pain

Symptoms that never occur with chronic hepatitis c: pain in the lower right abdomen, pain in the lower left abdomen, pain in the upper left abdomen, pain around the belly button

Urgency: Primary care doctor

Chronic kidney disease

Chronic kidney disease is long-term damage to the kidneys, the organs responsible for producing urine. Causes of chronic kidney disease include diabetes, hypertension, kidney infections, and inflammatory diseases, medications or toxins, inherited kidney diseases, and pre...

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Acute kidney injury

Acute kidney injury, also called acute renal failure or acute kidney failure, does not necessarily refer to a physical injury. It means that the kidneys have been severely damaged and are suddenly no longer able to filter wastes from the blood.

Anything that interferes with blood flow to the kidneys, or to the urine draining from them, will injure the kidneys. This includes: blood loss; clots; heart disease; high blood pressure; diabetes; infection; dehydration; lupus; toxins; and any number of medications.

An older person who is hospitalized, and/or critically ill, is most susceptible.

Symptoms include decreased urine output; swollen ankles; shortness of breath; nausea; chest pain; and sometimes seizures or coma.

Acute kidney injury is a medical emergency. Left untreated, it can result in permanent kidney damage or death. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through urine tests, blood tests, ultrasound or CT scan of the kidneys, and sometimes kidney biopsy.

Treatment involves hospitalization to treat the underlying cause of the kidney injury, and may include dialysis.

Rarity: Rare

Top Symptoms: abdominal pain (stomach ache), nausea or vomiting, urinary changes, shortness of breath, fatigue

Symptoms that always occur with acute kidney injury: urinary changes

Symptoms that never occur with acute kidney injury: vaginal bleeding

Urgency: Hospital emergency room

Dark Brown Urine Symptom Checker

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Urinary tract infection

A urinary tract infection is an infection of the urinary tract, which includes the kidneys, bladder, and urethra. Urinary tract infections are usually caused by infections by fecal bacteria.

Symptoms of urinary tract infections include pain with urination (dysuria), ...

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Autoimmune hemolytic anemia

Anemia is a condition in which the body does not have enough healthy red blood cells. In some cases, this can be caused by an attack of the immune system on the body's own red blood cells.

Rarity: Rare

Top Symptoms: fatigue, abdominal pain (stomach ache), fever, racing heart beat, joint pain

Symptoms that never occur with autoimmune hemolytic anemia: painful urination

Urgency: Primary care doctor

Urethritis

Urethritis is an infection of the urethra, which drains urine out of the body from the bladder. The urethra may be involved alone or with other structures in an overall urinary tract infection.

Urethritis is not a sexually transmitted disease (STD) in itself, but the same bacteria and viruses that cause STDs can also infect the urethra. Another common cause is the E.coli bacteria, found in feces.

Most susceptible are sexually active women, but anything that allows bacteria (especially E. coli) to travel into the urinary tract can cause an infection.

The most common symptoms are burning on urination and a cloudy discharge.

Diagnosis is made through urine test and a swab taken from the urethra. A urethritis patient should be tested for sexually transmitted diseases as well.

Treatment involves antibiotics, if the urethritis is caused by bacteria. Taking cranberry supplements can also be helpful, as long as the patient is not also taking the blood thinner called warfarin.

Rarity: Common

Top Symptoms: painful urination, penis pain, fluid leaking, pink/blood-tinged urine, cloudy urine

Urgency: Primary care doctor

Gall bladder infection (cholecystitis)

Gallbladder infection, also called cholecystitis, means there is a bacterial infection of the gallbladder either with or without gallstones.

The gallbladder is a small organ that stores bile, which helps to digest fats. If something blocks the flow of bile out of the gallbladder – gallstones, damage to the bile ducts, or tumors in the gallbladder – the bile stagnates and bacteria multiplies in it, producing an infected gallbladder.

Risk factors include obesity, a high-fat diet, and a family history of gallstones.

Symptoms include fever; chills; right upper quadrant abdominal pain radiating to the right shoulder; and sometimes nausea and vomiting. A gallbladder infection is an acute (sudden) illness, while the symptoms of gallstones come on gradually.

Untreated cholecystitis can lead to rupture of the gallbladder, which can be life-threatening.

Diagnosis is made through physical examination, ultrasound or other imaging, and blood tests.

Treatment involves hospitalizing the patient for fasting with IV fluids, to rest the gallbladder; antibiotics; and pain medication. Surgery to remove the gallbladder is often done so that the condition cannot recur.

Rarity: Uncommon

Top Symptoms: abdominal pain (stomach ache), nausea, loss of appetite, diarrhea, constipation

Symptoms that always occur with gall bladder infection (cholecystitis): abdominal pain (stomach ache)

Symptoms that never occur with gall bladder infection (cholecystitis): pain in the upper left abdomen, pain in the lower left abdomen

Urgency: Hospital emergency room

Rhabdomyolysis

Rhabdomyolysis is a syndrome most commonly resulting from muscle injury following extreme exertion such as endurance exercise or weight lifting or following a severe accident. Sometimes rhabdomyolysis may result from medications - most commonly medications to treat elevated cholesterol such as statins. Severity can range from mild to life threatening kidney disease from muscle enzymes entering the circulation.

Rarity: Rare

Top Symptoms: fatigue, nausea, muscle aches, being severely ill, change in urine color

Urgency: Emergency medical service

Dark Brown Urine Treatments and Relief

If the home remedies and lifestyle changes below do not help to improve your dark brown urine symptoms, make an appointment to see your physician. You and your physician can determine both the cause and the best course of treatment.

At-home treatment

Many causes of dark brown urine can be stopped or prevented with simple lifestyle changes.

  • Take note of your medications: If your dark brown urine is the result of medications you are taking, talk to your doctor about your options. Your doctor may discontinue your medication or suggest a similar alternative.
  • Notice your diet and the foods you consume: Very specific foods such as fava beans, rhubarb, and aloe cause dark brown urine. Cutting back on intake of these foods should resolve your changes in urine color.
  • Insufficient fluid intake can cause dark brown urine in severe cases: Drinking more water daily is a simple way to combat this symptom. Use a large refillable bottle and fill it with water to drink throughout the day or try to drink extra cups of water at mealtimes.

When to see a doctor

Your doctor will perform the following diagnostic tests in order to make the proper diagnosis. Dark brown urine treatment will be diagnosis-dependent and your doctor will discuss all of the appropriate options.

  • Urinalysis: Your doctor will take a urine sample in order to look for red blood cells, levels of protein, and excreted minerals and pigments in the urine that may indicate underlying kidney or urinary tract problems. Your doctor may also check for bacteria.
  • Blood tests: Certain blood tests can measure the level of waste products that build up in your bloodstream when your kidneys are damaged and not filtering properly. Your doctor may also check for elevated levels of liver enzymes that indicate liver damage.

When it is an emergency

If you experience severe pain with urination, blood in your urine, fever, or nausea or vomiting, you should seek immediate care.

Prevention

Not all causes of dark brown urine can be prevented; however, it is important to your overall health to stay adequately hydrated by drinking plenty of water. You should also be mindful as you eat certain foods mentioned prior that can lead to color changes, such as fava beans, rhubarb, and aloe.

Questions Your Doctor May Ask About Dark Brown Urine

To diagnose this condition, your doctor would likely ask the following questions:

  • Any fever today or during the last week?
  • Do you feel pain when you urinate?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Is your mouth very dry?

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your dark brown urine. These questions are also covered.

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Dark Brown Urine Symptom Checker Statistics

People who have experienced dark brown urine have also experienced:

  • 11% Bad Smelling Urine
  • 5% Abdominal Pain (Stomach Ache)
  • 4% Fatigue

People who have experienced dark brown urine were most often matched with:

  • 66% Dehydration
  • 33% Chronic Hepatitis C

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Dark Brown Urine Symptom Checker

Take a quiz to find out what might be causing your dark brown urine

References

  1. Sands JM, Layton HE. The physiology of urinary concentration: An update. Semin Nephrol. 2009;29(3):178-195. NCBI Link
  2. Sands JM, Layton HE. The physiology of urinary concentration: An update. Semin Nephrol. 2009;29(3):178-195. NCBI Link
  3. Shah AP. Urine, changes in color or odor. Merck Manual Consumer Version. Updated September 2017. Merck Manual Consumer Version Link
  4. Sobol J. Urine - abnormal color. U.S. National Library of Medicine: MedlinePlus. Updated December 6, 2018. MedlinePlus Link
  5. Rowe TA, Juthani-Mehta M. Diagnosis and management of urinary tract infection in older adults. Infect Dis Clin North Am. 2013;28(1):75-89. NCBI Link.
  6. Hemolytic anemia. National Heart, Lung, and Blood Institute. NHLBI Link
  7. Urine color and odor changes. Harvard Medical School: Harvard Health Publishing. Updated July 13, 2018. Harvard Health Publishing Link
  8. Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: Pathogenesis, diagnosis, and treatment. Ochsner J. 2015;15(1):58-69. NCBI Link