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What your urine color says about your hydration

Pale straw or light yellow urine usually means you are well hydrated. Dark yellow or amber usually means you need to drink more. Completely clear urine all day often means you are drinking more than you need. Color is a rough but useful everyday check, as long as you know what else can change it: foods like beets, vitamins, some medicines and certain health problems.

Why urine changes color

Urine gets its yellow color mainly from a pigment called urochrome, a breakdown product the body makes all the time at a fairly steady rate. What changes is how much water it is mixed with. When you are short on fluid, your kidneys save water and produce a smaller volume of more concentrated urine, so the same pigment looks darker. When you drink plenty, the kidneys let more water go and the color fades. Mayo Clinic puts it simply: normal urine ranges from clear to pale yellow, and fluids dilute the yellow pigment.

The color scale, shade by shade

Hydration charts used in sport, the military and hospitals are based on an 8-shade scale developed by Lawrence Armstrong and colleagues in 1994. In their study, urine color tracked closely with lab measures of urine concentration (specific gravity and osmolality). The authors concluded it was good enough for everyday and field use, though not precise enough for a lab. Here is how to read it in practice:

The NHS gives the same practical advice: aim for pale-colored urine, and treat dark yellow, strong-smelling urine as a sign to drink more.

How to check it properly

A few details make the check more reliable:

When color is not about water

This is where the chart can mislead you. Mayo Clinic lists many harmless and some not-so-harmless reasons for unusual colors.

Bright, neon yellow

The most common cause is a B-vitamin supplement or multivitamin. Riboflavin (vitamin B2) is naturally bright yellow-green, and the body excretes what it does not use. Mayo Clinic's riboflavin page notes it can make urine more yellow than normal, especially at high doses, and that this is no cause for alarm. It does mean the color chart is unreliable on days you take vitamins: you can be well hydrated and still have vivid yellow urine.

Red or pink

If you have not eaten beets or berries and are not on one of these medicines, red or pink urine needs checking by a doctor. Mayo Clinic notes that painless blood in the urine can be a sign of something serious.

Orange

Dehydration itself can push urine toward orange. So can vitamin supplements, some laxatives, phenazopyridine and certain chemotherapy drugs. Orange urine together with pale stools or yellowing skin or eyes can point to a liver or bile duct problem and needs medical attention.

Blue or green

Usually food coloring, dyes used in medical tests, or medicines such as the pain reliever indomethacin or the diuretic triamterene. Occasionally a urinary infection with certain bacteria.

Brown or cola-colored

Fava beans, rhubarb and aloe can cause it, as can some medicines. It can also come from severe dehydration, liver disease, kidney disorders or muscle breakdown after extreme exercise. Brown urine that does not clear up after drinking more, especially with muscle pain after a hard workout, needs prompt medical care.

Cloudy or foamy

Cloudy urine can come from a urinary tract infection or kidney stones, often with burning or a frequent urge to go. Occasional foam is usually just a strong stream; urine that is persistently very foamy can be a sign of protein in it and is worth mentioning to your doctor.

When to see a doctor

Get medical advice if:

Using color day to day

Color works best as a quick, private check that complements your drinking routine rather than replacing it. If it is often dark by the afternoon, you are probably front-loading too little in the morning; spreading your intake out helps more than a big catch-up in the evening (which may also have you up at night, see drinking water before bed). If you are not sure how much to aim for, start with how much water you should drink a day.

Water Tracker can take care of the "drink regularly" part: it suggests a goal based on your weight and activity, reminds you through the day, and lets you log a glass in one tap from your iPhone, Apple Watch or a widget. Your urine color then tells you whether that goal suits you.

Bottom line

Aim for pale straw. Dark yellow means drink more; clear all day means you can ease off. Judge it later in the day, in good light, not in the toilet bowl, and ignore the chart on days you take B vitamins. Red, pink, brown or persistently cloudy urine that food or medicine does not explain is a reason to see a doctor, not to drink more water.

This article is general information, not medical advice. If you have a health condition, are pregnant or take medication, ask your doctor how much you should drink.

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