If you ever rely on the “pee test” to check if you’re hydrated enough, consider adding the “sniff test” to your toilet bowl analysis. Yes, it might sound silly, but just like the color of your urine can give you clues about hydration and more, the way it smells can also reveal important things about your health.
Urine is produced by the kidneys and is made up of mostly water, as well as some level of the waste products that the organ is working to filter out, such as sodium, potassium, calcium, ammonia and chloride. When your urine is mainly water (a.k.a. you’re hydrated), it has minimal to no odor, whereas urine that has more waste products (a.k.a. you may be dehydrated), it will smell stronger, typically like ammonia, explains Cassandra Kovach, M.D., a nephrologist at Cleveland Clinic in Cleveland, Ohio.
But there are other scents that your pee can give off, and the reasons can range from the innocuous (like, say, you ate asparagus for dinner) to more serious (such as signaling an infection or chronic disease).
Here are some of the most common causes of smelly urine, plus what to do when you catch a whiff.
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Not getting enough fluids means your pee contains less water and a higher concentration of those waste products the kidneys are trying to filter out, so you’ll probably notice an ammonia-like smell and your urine will be a darker shade of yellow.
What to do about it: Fill up that water bottle and try to remember to regularly take some swigs. Try setting a phone alert that reminds you to sip every X amount of minutes; download a water tracking app that sends you in-app reminders; and as soon as you notice your bottle is empty, fill that baby back up! If you struggle with plain H20, alternate with delicious sparkling water or try adding some fresh fruit, cucumbers or fresh herbs to your water. “Drink enough water so that you don’t feel thirsty, and drink more in hot weather and when exercising,” Dr. Kovach says. However, if you have a condition such as heart failure or liver or kidney disease, always talk to your doctor before aggressively increasing your fluid intake.
2. Urinary tract infection (UTI)
A UTI can also cause your urine to give off an ammonia smell, but you’ll also likely have other recognizable symptoms such as burning or pain when urinating, blood in urine and an urgent or frequent need to urinate, says Dhruti Patel, M.D., a urologist at Mount Sinai Health System in New York City.
What to do about it: Make an appointment with your doctor, who can test to confirm you have a UTI and make sure it hasn’t spread to your kidneys. Until the infection passes, “increase your water intake to 100 ounces of water daily,” Dr. Patel says.
Uncontrolled or poorly managed diabetes may make your urine smell sweet or fruity because it contains extra glucose. You may also notice other signs that your blood sugar levels are off, such as feeling thirsty or tired, fruity smelling breath, or nausea and vomiting.
What to do about it: If you already know you have diabetes, check your blood sugar and take your regular steps for evening it out. If you haven’t received a diabetes diagnosis, schedule an appointment with your doctor so that they can help you begin treatment and make lifestyle changes that will help get your blood sugar levels under control and to a healthy place, says Dr. Patel, who also notes that it’s a good idea to decrease your sugar intake, too.
4. Liver disease
A very strong smell of ammonia or mustiness could signal liver disease; when your liver isn’t working as well, there will be more ammonia in your urine and blood. You may also have symptoms like yellowing of the skin and eyes, abdominal pain, nausea and vomiting, swelling of the abdomen and easily bruising or bleeding, says Dr. Kovach.
What to do about it: Talk to your doctor, says Dr. Kovach, who can test you for the disease and provide advice about treatment and next steps, which will depend on the stage of the disease. Depending on your diagnosis, you may only require lifestyle modifications with liver function monitoring, while other times a patient could require medication or surgery.
Bladder infections such as bacterial vaginosis may cause your pee to smell fishy and foul, and you’ll often have other symptoms such as unusual discharge. Some sexually transmitted infections (STIs) such as chlamydia can also change the smell of your urine, often because there’s discharge in it.
What to do about it: See your doctor to get tested and receive the medications or antibiotics needed to get rid of it.
6. Gastrointestinal bladder fistula
“This is an abnormal connection between the intestines and bladder,” and it can make urine stink like stool, says Dr. Kovach. “Someone can also get persistent and recurrent urinary tract infection and have gas come out of their urethra (the tube that drains urine from the bladder) as they urinate,” Dr. Kovach adds.
What to do about it: Schedule a doctor appointment. It often requires surgery to fix the damaged tissue.
7. Medication, vitamins, or antibiotics
Certain medications, supplements or antibiotics can make cause our pee to smell foul. For example, antibiotics that contain penicillin may lend a moldy scent to your urine, while certain vitamin supplements may cause it to smell stronger than usual.
What to do about it: If you’re taking vitamins and supplements, it can’t hurt to talk to your doctor to ensure your dose is correct, or those supplements are necessary. If your urine smells due to antibiotic use, it should go back to normal once you complete your treatment regimen.
8. Hormonal changes
Normal hormonal changes can change the smell of your urine. For instance, a symptom of menopause can be a different smell in your pee due to the dip in estrogen and changes to vaginal flora, while pregnancy may just make you more sensitive to scents, causing you to notice how your pee smells more than usual.
What to do about it: Your doctor can help you navigate both menopause and pregnancy to ensure your days are as happy and healthy as possible.
9. Certain foods
Your breakfast, lunch or dinner may be the reason behind funky scented pee. Garlic, onions and asparagus can lend your urine a rotten egg/rotten cabbage scent, says Dr. Kovach, while salty foods may make your urine smell stronger like ammonia. Brussels sprouts, coffee, honey, dried fruit, alcoholic beverages and fennel or black tea may also make your urine smell odd, Dr. Patel adds.
What to do about it: If it really bothers you, stop eating the food that’s making your urine smell. If you’re not sure which is the culprit, try tracking your food for a few days or a week and eliminating possible suspects until you find the right one.
10. Maple syrup urine disease
“Maple syrup urine disease is a rare genetic condition that is diagnosed in infancy,” says Dr. Kovach. “Babies often have other symptoms such as seizures, sleepiness, poor feeding, weight loss and irritability. It means there’s a deficiency in a certain enzyme complex that is needed to break down amino acids, and it results in an abnormal buildup of those amino acids and toxic byproducts.
What to do about it: The disorder is often detected through standard newborn screenings, but it’s possible for some cases to be discovered later. Maple syrup urine disease can be successfully managed through a specialized diet.
“Most of the time, when someone’s urine is smelly it does not mean they have a serious illness, and it goes away on its own. If someone’s urine has a strange odor, and it is caused by a medical condition, there are usually other symptoms present,” Dr. Kovach says. If you’re experiencing the latter, that’s when you should speak to your physician immediately.
Alyssa is a senior editor for the Hearst Health Newsroom, where she has written research-backed health content for Prevention, Good Housekeeping and Woman’s Day since 2017. She has more than 13 years of reporting and editing experience and previously worked as research chief at Reader’s Digest, where she was responsible for the website’s health vertical as well as editing health content for the print magazine. She has also written for Chowhound, HealthiNation.com, Huffington Post and more.
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