What should you know about really dark brown urine?

Urine becomes darker when it contains less water. Fluid loss from sweating, vomiting, diarrhoea or not drinking can make it look brown; read more about Dehydration. Heat exposure can add fluid loss and weakness, dizziness or headache; see Heat Exhaustion. Brown urine that stays dark after drinking normally may reflect bile pigments from a liver problem, blood breakdown, or muscle injury. New medicines, supplements and strongly coloured foods can also change urine. Colour alone cannot identify the cause.

Notice whether the colour changes after ordinary fluids and a rest from strenuous activity. Do not force large amounts of water quickly. Record when the change began, its shade, your fluid intake, recent exercise, foods, supplements and medicines. Look for yellowing of the eyes, pale stools, burning, pain or reduced urine. If the colour remains brown, arrange a clinical assessment; a urine sample and blood tests may help identify the source.

Seek urgent medical help for very little or no urine, confusion, fainting, severe weakness, severe abdominal or back pain, fever with illness, repeated vomiting, or brown urine after intense exercise with muscle pain. Arrange prompt care for yellow skin or eyes, pale stools, easy bruising, swelling, or urine that remains unusually dark. Dark urine can occur with Hepatitis A or Hepatitis B, but the symptom does not establish either diagnosis.

Ask: Could my medicines or supplements explain this colour? Do I need urine or blood testing? Could dehydration, liver irritation, blood breakdown or muscle injury be involved? Which warning signs should make me seek urgent help?