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What causes dark urine? Related conditions and treatments

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician
Updated May. 8, 2024  •  Published Oct. 10, 2023
Fact Checked
What causes dark urine?
In this article:

Overview: What does dark urine look like?

Urine is one of the primary ways the body eliminates waste products and usually appears pale yellow or straw-colored. Sometimes it’s a different color. Red urine, orange urine, brown urine, green urine, and even blue urine are all possible. Is weirdly-colored urine bad? Maybe, maybe not. Whether harmless or not, a color change in the urine usually means something in the urine that normally isn’t there. That’s all you know. It could be harmless, like food pigments, medication, or dyes, or it could be caused by something going wrong in the body. The most common problem that turns urine dark is dehydration because the urine is concentrated. That’s easily fixable by drinking enough water. The second most common cause is an excess of bilirubin, which the body produces when it breaks down dead red blood cells. This excess bilirubin is either due to too many blood cells breaking down, liver dysfunction, or blockage in the liver or pancreas. None of these are good. However, dark urine can also be due to blood in the urine, though it may be reddish and dark. That’s not a good sign; you’d need an investigation into the blood's source.

Key takeaways:

  • Dark urine is a common symptom that may be caused by dehydration, food, liver problems, kidney problems, muscle damage (like from excessive exercise or a car accident), biliary obstruction, cancer, or medication dye

  • Typically, dark urine does not require immediate medical attention unless there is blood in the urine or other severe symptoms.

  • Dark urine generally does not require treatment unless it persists for a few days, blood in the urine, or other symptoms. In some cases, dark urine will resolve without treatment. In others, healthcare providers will treat the underlying cause, which may or may not resolve with treatment.

  • Treatments of dark urine vary by cause. Read more about treatments for gallstones here, kidney stones here, kidney infections here, bladder cancer treatments here, malaria here, and hemolytic anemia (blood breakdown) here. 

  • Dark urine caused by dehydration can be managed by drinking more fluids. Other underlying causes of dark urine may require medical treatment.

  • Save on prescriptions for dark urine with a SingleCare prescription discount card.

What causes dark urine?

Any number of harmless or serious issues can cause dark urine. Some are related to urine concentration, some to pigments or dyes, but others to excess bilirubin or blood in the urine.

The most common reason urine is dark is dehydration. This causes urine to be concentrated and have a dark yellow or brown color. 

Another common reason urine is dark is excess bilirubin, the natural byproduct of the body’s breakdown of red blood cells. One way for bilirubin to build up is when too many blood cells die at once. This can be caused by:

Another cause of bilirubin excess is the body may be unable to clear it out of the blood. This is due to the liver’s inability to metabolize bilirubin or if the bilirubin disposal system, the bile ducts, are blocked. Medical conditions that produce these problems include:

Urinary tract problems usually cause blood in the urine. Sometimes, the blood will turn the urine red, which could turn it dark, maroon, or brown. Causes include:

Some conditions, foods, and drugs have pigments or dyes, or they may produce harmless substances in the body that discolor the urine. These include:

An acetaminophen overdose can also cause dark urine due to the buildup of a metabolite in the urine. This metabolite is toxic to the kidneys, and people who overdose on acetaminophen can die from kidney failure.

RELATED: Rhabdomyolysis symptoms: what are the early signs of rhabdomyolysis?

Should I be worried about dark urine?

Dark urine may be harmless, or it may be a sign of a potentially serious illness. Drinking fluids should help produce normal urine if it's due to dehydration. However, sometimes dehydration is a symptom of a more serious problem. Severe dehydration may require emergent medical care. 

Otherwise, if dark urine persists for a few days or is reddish in color or very dark, make an appointment to see a healthcare professional. Dark urine usually doesn’t require a trip to the emergency room unless there’s blood in the urine or other severe symptoms such as severe pain or high fever.

Dark urine itself does not have complications, but the underlying medical condition causing dark urine that goes untreated might have serious or life-threatening complications. For that reason, dark urine should be evaluated by a healthcare professional if it is persistent, accompanied by other symptoms, or involves blood in the urine.

How is the cause of dark urine diagnosed?

Many unrelated medical conditions can cause dark urine. This is because the kidneys are one way that people filter their blood. Muscle damage, red blood cell death, liver disease, pancreatic disease, gallbladder disease, kidney disease, and urinary tract problems are some reasons urine might be dark. For this reason, the diagnosis could require a complex work-up. 

The clinician will gather a thorough medical history: current and past medical conditions, history of dark urine, exercise habits, medications, drug use, diet, and other symptoms. Most serious medical conditions that cause dark urine usually have more worrisome or obvious symptoms like pain, severe pain, pale stools, jaundice, fever, or weakness. These are all better indicators of what the problem might be. 

A urine test is an excellent fast test to help identify whatever is darkening the urine. A physical exam and blood tests could unearth other signs of an underlying condition. Depending on the suspected cause, a clinician may order other tests like X-rays, a liver function test, and more blood or urinalysis tests.

RELATED: What can be detected in a urine test? 

Is dark urine contagious? 

Most conditions that cause dark urine are not contagious. However, some infections that cause dark urine may be contagious. At the top of the list is viral hepatitis, which can easily be spread through poor hygiene. Kidney infections and UTIs are usually not contagious. Malaria is uncommon in the U.S. and is not spread by person-to-person contact. 

RELATED: Hepatitis 101: how to prevent—and treat—an infection

How long does dark urine last?

If the cause is benign, dark urine is only a temporary glitch. Dehydration can be resolved by hydration unless the dehydration is severe. Urine darkened by foods or medications will return to normal once those foods or medications are stopped. Dark urine due to overexercise and muscle breakdown often improves with drinking water and stopping vigorous exercise.

Dark urine due to other underlying causes may take longer to resolve. Kidney stones, bladder stones, kidney infections, muscle damage, and gallstones may resolve with treatment in a few days or longer. Some conditions are long-term or lifelong, like sickle-cell anemia, porphyria, and liver cirrhosis. In those cases, dark urine and other symptoms may occur over the years.

How to stop dark urine

Sometimes dark urine has immediately recognizable causes such as dehydration, running a marathon, eating beets, or using senna, a popular laxative. In those cases, dark urine treatments involve drinking water, resting for a few days, not eating beets, or using a different laxative.

If a medical condition causes dark urine, healthcare providers will treat that medical condition. How to get rid of dark urine will depend on the underlying condition and its appropriate treatment.

RELATED: 7 health benefits of drinking water

Most importantly, see a doctor if worried

Even though dark urine is often a passing issue due to a benign cause, there are good reasons to worry about dark urine. There’s more than one serious medical condition that may be the cause.

How do you tell the difference between harmless and worrisome dark urine? Here are a few clues that you should talk to a healthcare professional:

  • Dark urine lasts for longer than 24 hours

  • Dark urine is not improved by drinking fluids

  • One or more other symptoms are present, like pale stools, weakness, fever, chills, jaundice, muscle pain, back pain, flank pain, abdominal pain, painful urination, discharge, pale skin, clammy skin, or discharge from the urethra

  • Dark urine is reddish or red, indicating blood in the urine

Only healthcare professionals are familiar with the myriad of conditions that can cause dark urine. They will know what to look for, what tests to perform, and the appropriate treatment.

What’s next? Additional resources for people with dark urine

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician

Leslie Greenberg, MD, is a board-certified practicing family physician with more than 25 years of doctoring experience. She was a psychology major at Northwestern University near Chicago, then graduated with an MD from the University of Nevada School of Medicine. She completed her family medicine residency at St. Joseph Hospital in Wichita, Kansas. She has trained more than 350 family medicine resident-physicians, been in private practice, and delivered babies for 22 years.

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