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As a urologist, I’ve learned to read the subtle signs in urine that can speak volumes about our well-being. It’s not just about frequency or urgency; it’s also about understanding the colour, clarity and odour of urine to unlock health insights.

The many colours of urine

Urine varies in colour from pale yellow to deep amber, primarily due to urochrome, a byproduct of the normal breakdown of red blood cells. As these cells age, they are broken down, and urochrome is made, which is then filtered by the kidneys and gives urine its colour. The intensity of this colour is a direct reflection of your hydration levels. The more hydrated you are, the lighter your urine.

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What colour is healthy urine?

Ideally, urine should be clear enough to read a book or text through (but there is no need to test my example). Yet it’s essential to find a balance.

Drinking too much water can lead to overhydration, which dilutes vital electrolytes and can cause water intoxication, a rare but serious condition that lowers blood sodium levels to dangerous lows. This risk is particularly relevant for athletes and individuals engaged in extended physical activity.

On the other hand, insufficient water intake risks underhydration, which can result in dehydration, fatigue, and weak cognitive and physical performance.

How much water should you drink?

When it comes to hydration, there’s no one-size-fits-all recommendation, but as a urologist, I can provide some guidelines to help you find what might work best for you. The US National Academies of Sciences, Engineering, and Medicine suggest about 15.5 cups (3.7 litres) of fluids a day for men and 11.5 cups (2.7 litres) for women, which includes all beverages and food. However, individual needs can vary greatly based on factors such as body weight, activity level and health status.

For a more personalized approach, I recommend starting with 30 millilitres (or 1 ounce) of water per kilogram (2.2 pounds) of body weight per day. This accounts for individual body mass differences and can be adjusted based on your daily activities. If you’re more physically active, or if you live in a hot climate, you might need to increase your water intake by 500 to 1,000 millilitres (about 17 to 34 ounces) per day.

It’s also important to adjust these recommendations for specific health conditions. For instance, patients with kidney stones might need more water to help manage their condition, while those with heart or kidney problems may need to limit their fluid intake.

Gender, age and health status also play critical roles in determining the right amount of water for you. Men typically require more fluids than women due to larger average body size, and older adults may need to pay more attention to hydration due to a decreased sense of thirst.

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Regardless of these guidelines, the best indicators of adequate hydration are rarely feeling thirsty and having light yellow urine. Listen to your body and adjust water intake based on thirst, the colour of your urine, and how you feel, ensuring you stay well-hydrated for optimal health.

What your urine colour is telling you

Red or pink: Sometimes, eating foods such as beets or berries can turn your urine red or pink. However, if you notice that your urine remains red or pink over time, it could mean there is blood in it. This change is something you shouldn’t ignore, and it’s a good idea to talk to a doctor about the change as it may be a red flag for cancers of the bladder and kidneys or benign conditions such as an enlarged prostate.

Dark brown or tea-coloured: Urine that looks dark brown or like tea could be a sign that you’re not drinking enough water. If you’ve been drinking plenty of fluids and your urine is still dark, it might be a sign of liver problems or other health issues.

Blue or green: Seeing blue or green in your toilet bowl might be surprising, but it could be due to certain medications or dyes in foods.

Vibrant yellow: B vitamins can infuse your urine with a vibrant yellow shade. This effect, while harmless, is a good reminder of how diet and supplements can influence bodily functions.

What does your urine clarity mean?

Cloudy urine can be a sign of an infection or a problem with your kidneys.

Additionally, it’s worth noting that the presence of semen in urine can also change the clarity of urine, making it appear cloudy.

A cloudy appearance is often benign and resolves on its own and could be natural or a side effect of medications or surgeries for an enlarged prostate.

What does your urine odour say?

Urine typically has a mild odour, but strong or unusual smells can indicate a problem. A strong ammonia scent could suggest dehydration. A foul or unusual smell could be a sign of a urinary tract infection.

Consuming certain foods, particularly those that are spicy or contain strong ingredients, can also affect the odour of your urine.

Foods such as asparagus, coffee and some fish can produce a distinctive smell due to the specific compounds they contain, which are excreted in the urine.

A urinary ‘report card’

When it comes to understanding your health, your urine can act like a daily report card. Paying attention to its colour, clarity and odour offers valuable clues that might indicate underlying health issues.

If you notice changes in your urine that don’t go back to normal, it’s better to be safe and talk to a health care provider.

Remember, catching potential health issues early can make all the difference. So, before you flush next time, take a quick look — it could be more informative than you think.