What causes orange urine? Related conditions and treatments

Overview: What does orange urine look like?

Changes to the color of your urine color can signal many things, from harmless glitches, such as food dyes, to more serious medical conditions, such as liver or kidney problems. Normal urine is pale yellow because of the presence of urobilin (urochrome). Sometimes, however, urine can change into a rainbow of colors: dark yellow urine, pink urine, red urine, orange urine, blue urine, tea-colored urine, dark brown urine, blue urine, green urine, and cloudy urine are all possible. Discolored urine can seem startling, especially if it’s an unusual pigment like orange. Orange urine is usually the result of harmless causes like foods or supplements. Dehydration, too, might sometimes be the issue. But it can also be due to a serious problem like liver or bile duct problems. People with orange urine may experience other urination changes, such as frequent urination or bad-smelling urine. They may have other symptoms like pale stools, fatigue, or skin color changes.

What causes orange urine?

The most common causes of orange urine are:

• Foods

• Dietary supplements and vitamins

• Medication side effects

• Liver or bile duct problems

Less likely but possible causes of orange urine include:

• Dehydration

• Blood in the urine

Foods that can cause orange urine are usually those high in beta-carotene, a precursor molecule of vitamin A. These include:

• Carrots and carrot juice

• Beets

• Sweet potatoes

• Cantaloupe

• Squash

• Rhubarb

• Blackberries

Dietary supplements can also cause orange urine, particularly when taken in excess. These include:

• Beta carotene

• Vitamin A

• Vitamin C

Medications that cause orange urine include:

• Laxatives containing senna

• Some chemotherapy drugs

• The anti-inflammatory drug Azulfidine (sulfasalazine)

• The tuberculosis medication rifampin

• The urinary tract pain medication Pyridium (phenazopyridine)

• Use of Desferal (deferoxamine), a drug intended to remove excess iron from the bloodstream, also turns urine orange because of the iron in the urine

Orange urine can also be a sign of problems with the liver or bile ducts. In these cases, orange urine, tea-color urine, brown urine, or dark brown urine is due to bilirubin and similar compounds building up in the blood and being excreted through the urine. Underlying causes include:

• Hepatitis

• Liver cirrhosis

• Liver cancer

• Gallstones

• Pancreatitis

• Pancreatic cancer 

Dehydration may make urine appear dull or dark orange, but not usually. Normally, dehydration causes urine to change to a dark yellow color. As the urine gets more concentrated, the urine turns an even darker yellow and eventually brown. Urine color changes very rapidly in response to hydration and dehydration, so orange-colored urine due to dehydration usually doesn’t last long.

Blood in the urine might also make the urine appear orange-colored, but this is uncommon. It takes very little blood to turn yellow urine into pink urine. Even more, blood produces red urine. Sometimes, however, the mixture may appear red-orange in color. Common causes of blood in the urine include:

• Urinary tract infections

• Kidney stones

• Kidney disease

• Tumors

Uric acid crystals are another possible cause of orange urine, but this, too, isn’t common. Uric acid crystals typically turn urine pink. Sometimes, they may turn urine red-orange or orange-brown. Newborn infants, in particular, are prone to uric acid crystals, which then turn urine a pink or peach color, but sometimes it may appear orange. 

RELATED: What happens if you eat too many gummy vitamins?

Should I be worried about orange urine?

Unless there are other symptoms, orange urine should not be a cause for worry. If there’s a clear cause, like drinking too much carrot juice or overdoing vitamin C supplements, the orange urine should clear up once the problem is corrected. As a sign of dehydration, orange urine isn’t an alarming symptom unless it’s dark, but it is a sign to start drinking fluids. 

If orange urine persists or there are other symptoms, see a healthcare provider. Symptoms to watch for are pale-colored stools, fatigue, abdominal pain, or yellowing skin or eyes. These are signs that orange urine may be due to liver problems or bile blockage. If orange urine is accompanied by severe symptoms such as high fever, mental changes, severe abdominal pain, or blood in the urine, get immediate medical attention.

How is the cause of orange urine diagnosed?

Orange urine is not a very specific symptom. It’s usually caused by foods, dietary supplements, or medication side effects. Liver problems or bile duct problems may turn urine orange, but they may also turn urine brown. In less common cases, blood in the urine may be the cause.

The healthcare provider will start with a thorough medical history. Be prepared to answer questions such as:

• When did you first notice the urine was discolored?

• Is it always orange? Or is it other colors?

• Do you notice any blood in the urine?

• What color are your stools?

• Are there any other symptoms?

• Do you feel any pain?

• What do you usually eat?

• What supplements do you take?

• What medications do you take?

• Do you have a history of liver problems?

The clinician will also perform a physical examination and look for other symptoms like pain, tenderness, yellowing skin, fever, or weakness. A urine test will usually be required. The clinician may also need blood tests, a liver function test, or X-rays.

RELATED: What can be detected in a urine test? 

How long does orange urine last?

Urine is continually changing colors. Because so many factors influence what urine looks like, it’s a dynamic measure of what’s going on in the body. Like all urine color changes, orange urine is usually a temporary issue. Most causes of orange urine, like dehydration, foods, or medications, are eventually resolved, sometimes very rapidly. 

• Dehydration might get worse, turning the urine dark, or it might get better, so urine returns to its normal color 

• Orange urine due to foods, supplements, and medicines will continue to be orange for as long as those foods, supplements, and medicines are being taken

• Liver disease and biliary blockage might eventually turn the urine dark

• Blood in the urine may eventually turn the urine pink or red 

How to stop orange urine

If the cause is harmless, orange urine should return to normal by addressing the underlying cause: 

• Orange urine due to foods or supplements resolves by cutting back

• Orange urine due to medicines will resolve when the medications are discontinued

• Mild or moderate dehydration can be resolved by drinking fluids, but severe dehydration may require intravenous fluids 

Liver disease and biliary obstruction have a variety of causes. Some may be treatable and others may be chronic or lifelong conditions.

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

Test and diagnostics

• Orange urine: what it means and when it’s cause for concern, HealthGrades

• Understanding your liver panel results, SingleCare

• Urinalysis, StatPearls

• Uroscopic rainbow: Modern matula medicine, Postgraduate Medical Journal

• What can be detected in a urine test?, SingleCare

Treatments

• Biliary obstruction, StatPearls

• Urine changes, Cleveland Clinic

Scientific studies and clinical trials

• Acute iron intoxication: change in urine color during chelation therapy with deferoxamine, Intensive Care Medicine

• Reddish-orange discoloration of urine due to uric acid crystalluria after recurrent seizures, Nephrology Image