Unless you’re potty-training a toddler (ahem) urine probably isn’t something you think about much on the regular. However, the appearance of your pee can both clue you in to your body’s needs and give you a heads up if something is off-kilter. And you may have wondered on more than one occasion: Why is my pee cloudy? Typically, a well-hydrated person’s urine should be clear to light yellow, says Dr. Brian Stork, MD, assistant clinical professor in the department of urology at the University of Michigan and chairperson of the Urology Care Foundation’s Patient Education Council. Darker-than-normal urine means your body needs more fluids, particularly after exercise or exposure to weather that’s warm enough to make you sweat. But urine isn’t just a barometer of how you’re doing on hydration. A peek at your pee’s transparency can mean a multitude of things: Cloudy pee, which may be described as “hazy” or “milky” in appearance, could signal one of the following medical issues, Dr. Stork says.
Reasons your pee is cloudy
You’re dehydrated
When your body’s low on fluids, it does what it can to conserve the water it’s got. As a result, your urine, which is comprised of waste, minerals, salts, and water, becomes more concentrated and begins to appear cloudy, says Dr. Stork.
You’ve got a UTI
Cloudiness can be caused when bacteria travel up the urethra and causes an infection in one of four places, says Dr. Stork: One or both of the kidneys (aka pyelonephritis); the bladder (aka cystitis); the urethra (urethritis); or in males, the prostate (prostatitis). This is due to the body’s inflammatory response, which increases cell turnover and sends dead cell debris into the urine, which changes its concentration, says Dr. Amy M. Valent, DO, assistant professor of obstetrics and gynecology at Oregon Health and Science University. But it’s worth noting that you can still have a UTI without this particular symptom: “Not everyone will have cloudy urine with a UTI,” she says.
You have bacteria in your urine
Different from a straight-up urinary tract infection (UTI), asymptomatic bacteriuria is defined by bacteria in the urine that causes no symptoms. The good news is that it doesn’t necessarily have to be treated—for the most part, no symptoms, no problem.
You’ve got an STD
Sexually transmitted diseases can cause both acute and chronic inflammation in the urethra in both women and men, Dr. Stork notes, explaining that urine can become cloudy as it passes through an inflamed urethra. Before you freak, note that urine cloudiness is far from a surefire sign you have—or have not— been infected, says Dr. Valent. “Vaginal flora can contaminate the urine,” she agrees. “But it depends on the severity of the STD in the vaginal tract.”
You have vulvovaginitis
Marked by inflammation of the labia and vagina, this condition can cause the urine to appear cloudy as it passes out the female urethra and into the toilet, Dr. Stork says. While the inflammation is caused by fungus, Dr. Valent chalks up cloudy pee not to said fungus, but to the inflammation itself, which can increase cell turnover and the amount of dead cell debris that gets caught up in your urine.
You have stones
Stones, which are made of naturally occurring salts and minerals in the urine that begin to crystalize and coalesce, can develop anywhere along the urinary tract but are most often found in the kidneys, ureters, bladder, Dr. Stork says. While these crystals and stones can cause cloudiness directly, they’re often accompanied by blood in the urine, which can further mess with its appearance.
You have diabetes
“The body doesn’t like blood sugar above a certain set point,” explains Dr. Valent. As such, in people with diabetes who struggle with blood sugar management, the body can dump sugar into the urine, changing its concentration and contributing to a cloudy appearance. “Depending on the severity of diabetes, kidney dysfunction can also contribute to changes in the concentration of urine,” she adds. See, the kidneys typically help regulate blood sugar through filtration and reabsorption of sugar and protein. But in diabetics, injury to the glomeruli cells, which filter the blood in the kidneys, can lead blood sugar and protein to spill over into the urine, which can make it appear cloudy, says Dr. Stork. What’s more, diabetes can also increase the risk of UTI infections that cloud the urine, since the sugar in the urine can cause bacteria to proliferate, according to Dr. Valente.
Your pee is full of protein
Another one of the kidneys’ main roles is to reabsorb protein to prevent it from being lost in the urine, Dr. Stork says. Kidney damage can mess with this system so protein isn’t returned to the bloodstream, but released into the urine in a condition known as proteinuria, which contributes to a cloudy appearance.
Other things to look out for in your urine
While it may not make your urine look cloudy, per se, blood in the urine can be related to a urinary tract infection, stones, genitourinary cancer, ruptured blood vessels, or kidney issues, says Dr. Stork. While being armed with this info may make you feel like an attending physician on Grey’s Anatomy, don’t play your own doctor—notify your primary care physician at the first sign of blood in the urine to get things checked out. If your urine looks just fine but the scent is just not right, a sweet or fruity smell is a reason to see a doctor. After all, urine with these notes can be a symptom of diabetes, says Dr. Stork. On the other side of the spectrum, if your pee smells so foul that you’re moved to plug your nose, bacteria could be to blame. In this case, you’d be smart to visit your doctor for a UTI screening. Of course, a new scent may be no cause for alarm. After all, foods and beverages like asparagus and even coffee can make your urine smell different, Dr. Stork says. It’s simply part and parcel of a varied diet. At the end of the day, “lots of factors can influence urine concentration and output, from the foods you eat to how hydrated you are, and whether you just ran a marathon or have been sedentary,” Dr. Valent says. It’s ever the more reason to see your healthcare provider for an evaluation if any fluid that leaves your body seems off. Next up: Peeing a Lot? Here Are a Few Reasons Why
Sources
Dr. Amy M. Valent, DO, assistant professor of obstetrics and gynecology at Oregon Health and Science UniversityDr. Brian Stork, MD, assistant clinical professor in the department of urology at University of Michigan and chairperson of the Urology Care Foundation’s Patient Education CouncilAsymptomatic Bacteriuria. Harvard Health.The Meaning Behind the Color of Urine. Urology Care Foundation.
