Urine - Facts, Health Concerns & Remedies

Urine

Facts
Albumin
Bilirubin
Creatinine
Urea
Ketones
Nitrites
N-Telopeptides & pyridinium cross-links
Hematuria
Colors of urine
Urinary tract infection
Kidney stones
Incontinence
Animals & their urine
Fabric care
Books & articles
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Facts

Urine is made up of water, urea, sodium chloride, potassium chloride, phosphates, amino acids, uric acid, organic and inorganic compounds, urobilin, hormones and enzymes.
The kidneys make urine by filtering out unwanted water, waste products, chemicals, sodium and potassium ions from the blood through a set of filtering systems called nephrons. Through a complex process, the kidneys return an exact amount of sodium and potassium ions and some water to the blood stream so as to maintain a constant water and salt balance in the body. The urine journey continues from the kidney through a long thin tube called the ureter and enters the bladder where it is stored.
When the nerves of the bladder send out a feeling-of-fullness signal, urine is now ready to be dispensed through the urethra.
The average amount of urine excreted in 24 hours is 40 to 60 ounces.
Normal urine is colored pale yellow by yellow pigments such as urochrome, urobilin and uroerythrin. They are normal metabolic end products.
The acid found in urine gives off that typical urine smell. In diabetics, urine may smell fruity due to the presence of glucose.
Freshly made urine from the kidney is sterile but when it leaves the body, it is exposed to bacteria present in the surrounding or on the skin. A bacterial invasion leads to a breakdown on the salts in the urine to give off a foul-smelling odor. If urine smells offensive the minute urination starts then there is already an infection in the urinary tract. Still, an insignificant amount of bacteria may be present in the urine of healthy people.
Alcohol and caffeine have a diuretic effect, that is, the body makes more urine.
Pregnant women may experience an increase in urinary frequency and stress incontinence (due to the additional weight on the bladder).
Some people with vertigo also have high levels of mercury in their urine tests and hair analyses. Mecury found in the body usually comes from the dental fillings.
Anxiety can affect the nerves that control the bladder which promptly results in more trips to the restroom to urinate.
Urine testing is used to detect gonorrhea and chlamydial disease, 2 sexually transmitted bacterial infections.
As a man grows older, the prostate gland grows bigger. This enlargement may not pose any problem but when it does, it causes urinary symptoms such as incontinence, difficulty to start urinating, slow and/or interrupted stream, increased need to pass urine frequently and a feeling that the bladder is still full.

Albumin

Albumin is a protein produced in the liver that moves around in the blood, responsible for maintaining proper pressure between the various fluids in the bloodstream and the surrounding tissues. It plays a role in transporting fatty acids, hormones and medications in the blood. Under normal circumstances, proteins are not allowed into the urine because the glomerulus (part of the kidney nephron which filters fluid from the blood) prevents large molecules (like proteins) to pass through and would retain proteins in the blood rather than excrete them out.
The albumin urine test is a measure of the albumin level in the urine, used primarily to evaluate kidney (renal) function.
Microalbuminuria refers to a small amount of albumin whereas proteinuria refers to a large amount of albumin present in urine.
Other causes of abnormal levels of albumin in the urine could be due to a fever, very strenuous exercise or exposure to cold. Such abnormalities should return to normal values.
Studies have found that the excretion of albumin in urine is the best predictor of progressive kidney failure in people with Type 2 diabetes. Also, a high level of urine albumin could signal the development of heart disease.
Reference : "Development and Progression of Renal Disease in Pima Indians with Non-Insulin-Dependent Diabetes Mellitus" Robert Nelson, et al. New England Journal of Medicine (Nov, 1996) 335:1636-1642 [Note : Pima Indians were the world's highest number of Type 2 diabetics and 20 times more end-stage renal disease than the general population in America]
Very high levels of albumin in the urine will indicate that the kidney is failing and can no longer be of service. Low levels of albumin in the blood indicate liver disorders such as cirrhosis, severe hepatitis or an injury that has affected the liver's ability to produce albumin.

Bilirubin

Bilirubin is a yellow-orange compound that comes from the breakdown of hemoglobin in red blood cells by phagocytic cells (cells that consume and digest other cells). Hemoglobin is broken down into 2 parts, heme and globin. The heme is converted into bilirubin while the globin is split off to amino acids used for protein synthesis.
Bilirubin is secreted into the blood and carried to the liver where it is conjugated with glucuronic acid. Conjugated bilirubin (also called direct bilirubin) is excreted in the bile as bile pigments into the small intestine. Bile is an emulsifying agent produced in the liver and secreted into the duodenum (the part of the small intestine between the stomach and the jejunum). Bile helps to digest fats in the duodenum. Its composition includes bile acids, bile salts, cholesterol and electrolytes.
Bilirubin is further metabolized by bacteria in the intestine to form 3 colorless pigments known collectively as urobilinogens upon the removal of the conjugated glucuronic acid : stercobilinogen (6 hydrogen atoms), mesobilirubinogen (8 hydrogen atoms) and urobilinogen (12 hydrogen atoms).
These 3 compounds in the intestine are oxidized to become urobilin, mesobilin and stercobilin, which turn feces somewhat brownish.
A small amount of urobilinogens can get reabsorbed into the blood from the intestines and 90% of these urobilinogens will eventually land up in the liver through the portal veins (then re-excreted into bile) while the remaining 10% will be excreted into urine. Urobilinogen in urine is converted to yellow urobilin.
Abnormal levels of urobilinogens in the urine can be caused by liver disorders, hepatitis and hemolytic anemias (a destruction of red blood cells throughout the bloodstream).

Creatinine

Creatinine is a waste byproduct of muscle metabolism where creatine phosphate in muscle is broken down.
The creatinine clearance test is a measure of the creatinine level in the urine, used primarily to evaluate kidney function.
With normal kidney function, the serum (blood) creatinine level should remain constant and normal. A high level of creatinine in the blood and a low clearance value in the urine will tell that the kidneys are unable to excrete creatinine in the urine efficiently. A normal reading is 97 to 137 ml/min (milliliters per minute) for a male and 88 to 128 ml/min for a female.
High creatinine clearance values can be caused by strenuous exercise, pregnancy and muscle injuries.

Urea

Urea is a toxic end product from protein metabolism. During digestion protein is broken down to amino acids and amino acids contain nitrogen, which is removed as NH4+ (ammonium ion). The ammonia is combined with other small molecules to produce urea in the liver. The urea is carried by the blood and heads for the kidney to be eliminated in the urine.
A high-protein diet will generate more urea and that can expose the liver to more toxic from the nitrogenous residues while increasing the workload on the kidneys.
The blood urea nitrogen (BUN) test is a measure of the amount of urea nitrogen in the blood, used primarily to evaluate renal function. A healthy reading is 7 to 20 mg/dl.
The urine urea nitrogen (UUN) test is a measure of protein breakdown in the body. It is also used to assess the protein balance and the amount of dietary protein needed by severely ill patients.
The ratio (U/P urea) between urine urea and plasma (blood) urea is an indicator of how efficient the kidneys are able to filter and excrete urea from the blood.

Ketones

Ketones are end products formed when the body breaks down muscle and fat to burn as fuel, this act of fuelling happens when there is a glucose buildup in the blood. The ketones enter the blood stream and are excreted in the urine. The ketone phenomenon can be caused by uncontrolled diabetes, starvation, fasting and alcohol intoxification.

Nitrites

The level of nitrites in the urine increases with bacterial infection.

N-Telopeptides & pyridinium cross-links

Collagen is the main protein that holds the bone structure together. The telopeptides link and stabilise collagen molecules.
Pyridinium cross-links are found in most connective tissues, they join adjacent collagen molecules within a fibril. There are 2 forms of pyridinium cross-links : pyridinoline (Pyr) and deoxypyridinoline (Dpyr).
When collagen breaks down, N-Telopeptides of Type 1 collagen (NTx) fragments, along with pyridinoline and deoxypyridinoline are carried in the blood and excreted in urine.
The NTx test is a measure of the NTx levels in the urine, while the pyridinium cross-links test measures the urinary excretion of Pyr and Dpyr. These tests are used to evaluate the risk of osteoporosis. Increased bone resorption will lead to increased excretion of NTx, Pyr and Dpyr.

Hematuria

Hematuria means blood in the urine.
Gross hematuria means that blood can be seen in the urine with the naked eye. Microscopic hematuria indicates that blood traces can only be seen when the urine is examined under a microscope.
Hematuria makes the urine red to brown, depending on the amount of blood present, how long the blood has remained in the urine and the acidity of the urine.
Hematuria can be due to a variety of reasons such as cancer, infections, kidney stones, obstructions or injury of the urinary tract, viral infections, kidney inflammation, benign prostate enlargement and anticoagulant drugs.
Cancer of the kidney or bladder can lead to intermittent bleeding without any pain. The bleeding may stop though the cancer does not.

Colors of urine

BLUE/GREEN
Certain medications such as urolene blue, urised and trac which are used to reduce symptoms of urinary tract infections contain a blue dye (e.g. methylene blue) which will color urine blue or green.
An inherited form of high calcium ("familial hypercalcemia") can result in blue urine, nicknamed the "blue diaper syndrome".
Reference : "The blue diaper syndrome: familial hypercalcemia with nephrocalcinosis and indicanuria. A new familial disease, with definition of the metabolic abnormality." Drummond KN, et al. American Journal of Medicine (1964) 37:928-948
Asparagus can make urine green and smelly.
BROWN/BLACK
Brown or black urine (not due to myoglobin or bilirubin) may be caused by excessive L-dopa (a drug used to slow down the progression of Parkinson's disease) or melanin (the pigment that colors eyes, skin and hair) excretion. Can also be caused by copper or phenol poisoning.
Reference : "Thirty-three drugs that discolor urine and/or stools" Slawson M. RN (Jan 1980) 43(1):40-1
Taking in large amounts of rhubarb, fava beans, or aloe can turn urine dark brownish black.
Reference : "Causes of dark urine" Noll WW, et al. Journal of the American Medical Association (1980) 243(23):2398
RED/ORANGE/YELLOW
Phenazopyridine hydrochloride (Brand names : Pyridium, Pyridiate, Pyridium, Urodine, Urogesic, Viridium), prescribed for bladder infections is a urinary anesthetic. The phenazopyridine can color the urine reddish orange.
Rifampin (to treat all forms of tuberculosis), sulfasalazine (to treat ulcerative colitis and Crohn's disease), Vitamin B2 (riboflavin), Vitamin C, multivitamins (which contains riboflavin) and carrots can contribute to the dark yellow to orange look.
Beets and blackberries can turn urine red due to the presence of anthrocyanin, a flavonoid.
Urates in babies stain the diaper orange-to-red.
If the urine color displays a concentrated, bold yellow hue, it clearly indicates that the body is dehydrated and is in need of water.
The presence of myoglobin (a red iron-containing protein pigment) from broken down muscle cells will give a brownish-red color. Often associated with ischemic muscle damage, crush injuries and after vigorous exercise. The presence of hemoglobin (an iron-containing respiratory pigment) from broken down red blood cells will color urine red. See Hematuria.
The pigment bilirubin turns the urine yellow or brown in color.
WHITE
White or cloudy urine is often a result of phosphaturia, the precipitation of phosphate crystals in the urine. Phosphaturia can occur after a meal or after drinking a large quantity of milk.
Crystals from uric acid or pus (consisting of white blood cells) from a urinary tract infection can also make urine cloudy.
A bacterial infection can turn urine cloudy as well.

Urinary tract infection (UTI)

Juices from blueberry, cranberry have anti-bacterial fighting capabilities. Researchers at the Weizmann Institute of Science found that the juices of blueberry and cranberry contain a compound called proanthocyanidin that weakens the adhesive bonding between Escherichia coli (E.coli) and the tissue of the urinary and digestive tract linings which the bacteria attaches to. E.coli is the bacteria responsible for UTI.
Grapes (their skin and seeds) are another source of proanthocyanidins.
Noni juice contains anthraquinone compounds such as alizarin, acubin and L-asperuloside that fight against bacterial strains like E.coli. With lots of water plus noni's acidifying action on the urine, it will give E.coli less reason to stick around. TAHITIAN NONI™ Juice contains noni plus blueberry and grape juice.
For serious acute conditions such as kidney or urinary tract infections, Ms. Isabelle Navarre-Brown, author of 76 Ways to Use Noni Fruit Juice (Direct Source, 2001) suggests drinking 5 to 8 ounces of noni juice daily - 1 ounce upon waking up in the morning, 1 before bed while spreading the balance doses throughout the day. Continue with drinking pattern for a week or so after the symptoms disappear, then reduce the daily dose to a maintenance dose. For serious chronic conditions, this drinking pattern may have to continue for many months, even if one starts to feel better. Always take plenty of water before and after taking noni juice to help the body absorb the juice and flush toxins from the system. See Recommended dosing.
More about noni.
References : "Cranberry proanthocyanidins and the maintenance of urinary tract health" Howell AB. Critical Reviews in Food Science and Nutrition (2002) 42(3):273-278; "Morinda citrifolia (Noni): A literature review and recent advances in Noni research" Wang Mian-Ying, et al. Acta Pharmacologica Sinica (Dec, 2002) 23(12):1127-1141
Shun from tight pants, synthetic underwear and avoid deodorant soaps, all of which can encourage bacteria growth.
Many women experience an infection shortly after a pelvic test. To solve this problem, drink a glass of water just before and after the visit to the gynecologist.

Kidney stones

The formation of kidney stones begins when the urine is highly concentrated and the calcium oxalate found in urine crystallizes. Calcium and oxalate (found in cranberries, strawberries, asparagus, beets, beet greens, rhubarb, spinach, nuts and chocolate) are obtained from the diet.
These stones not only make urination torturing but cause blood in the urine and create severe pain on the lower back, side (flank) of the back or groin.
To reduce risk of kidney stones, drink lots of water daily to dilute the urine. Begin with 2 liters daily.
Take plant-based protein which is not linked to stone formation unlike animal protein.
Refrain from chocolates and beverages that contain caffeine which increases urinary calcium.
Take noni juice with lots of water. Noni's acidifying of the urine help dissolve stones and prevents the formation of new ones.
See Recommended dosing.
More about noni.
Purine can raise blood levels of uric acid which could promote certain kinds of stone containing uric acid. Purine-rich foods include anchovies, brewer's yeast, organ meats and sardines.
Consume foods containing potassium which prevents calcium crystallization, which contributes to stone formation.
Insoluble fiber binds with oxalates in the intestine which the body does not absorb and will be eliminated with the fecal waste.
Kidney stones have been linked with a deficiency of vitamin B6. Together with magnesium, they can help excrete less oxalate to protect against calcium stones.
Dandelion leaf tea can help promote urinary excretion of uric acid.

Incontinence

Incontinence is the leaking of urine brought about when one sneezes, coughs, laughs or exercises.
For stress incontinence sufferers, avoid lifting heavy objects.
Go to the toilet only when there is a need.
The astringent effects of horsetail has been used to treat incontinence.
Use the Kegel exercise to help strengthen the pelvic floor muscles which support the bladder, rectum and in women, the uterus.
To locate these muscles, pretend to stop the flow of urine and wind, the muscles that feel tighten are the ones that need training. [Note : If unsure whether the correct muscles have been identified, try stopping the urine flow when urinating, then release it. Do this only to identify the correct muscles for this is not part of the exercise.]
The exercise : contract the pelvic floor muscles and hold for 10 seconds (or at least 2 seconds for initial attempts). Relax the muscles slowly for an equal amount of time. Repeat this contraction 5 to 10 times. Do this workout once every hour or at least 8 times daily. This exercise can be done in a standing, sitting or lying down position.

Animals & their urine

Estrogen extracted from pregnant mares' urine is used to make premarin, a hormone replacement drug for menopausal women.
Some animals protect themselves from a specific predator by smearing their bodies with the urine or faeces of that predator. According to William Agosta's book "Bombardier Beetles and Fever Trees: a close-up look at chemical warfare and signals in plants and animals", Siberian chipmunks will smear themselves with snake urine or faeces whenever they can because snakes were less likely to attack them.
Fox and wolf urine can be used to keep rabbits, rodents, deers and cats away from the lawn or garden.

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