Causes of dark urine with odor

A stronger ammonia-like smell can occur when urine is concentrated, especially after sleep, sweating, vomiting, diarrhoea, or limited drinking. Certain foods, vitamins, and medicines may add a distinctive smell. A foul smell with burning, urgency, frequent small amounts, lower abdominal pain, or cloudy urine can occur with a urinary tract infection. Sweet or fruity odour with feeling very unwell needs prompt assessment. Brown urine, pale stools, or yellow skin and eyes point toward a possible liver problem such as hepatitis A or hepatitis B rather than simple concentration.

Drink fluids steadily if you have no fluid restriction, and compare the next few urine samples rather than relying on one morning sample. Note new foods, supplements, medicines, heat exposure, and bowel symptoms. Do not use leftover antibiotics or scented products to mask the smell. A clinician can test urine for infection, blood, or other changes and decide whether blood tests are needed.

Contact a clinician promptly if the smell and dark colour last beyond a day, recur, or come with fever, chills, back or side pain, burning, or reduced urine. Seek urgent care for confusion, fainting, severe weakness, repeated vomiting, inability to drink, marked yellowing, or severe pain. A person who is pregnant, older, or immunocompromised should seek advice early when urinary symptoms appear.

Could this be dehydration or a urinary infection? Should I provide a urine sample? Could a new medicine or supplement be responsible? Which symptoms would mean I need same-day care?