Smelly dark urine: symptoms of what?

Urine can become darker and stronger-smelling when it is concentrated after sweating, vomiting, diarrhoea, fever, or simply drinking less. Dehydration may also cause thirst, a dry mouth, headache, or passing urine less often. Heat Exhaustion can cause heavy sweating, weakness, dizziness, nausea, and dark urine after heat exposure.

Brown or tea-coloured urine, yellowing of the skin or eyes, pale stools, nausea, or pain under the ribs can occur with liver inflammation such as Hepatitis A or Hepatitis B. Food, supplements, and medicines can also change urine colour or odour. A urine or blood assessment may be needed to separate these causes.

If you feel well and have been losing fluid, drink regularly and monitor whether the urine becomes lighter over the next several hours. Rest somewhere cool after heat exposure and avoid strenuous activity until you feel recovered. Do not force fluids if a clinician has told you to restrict them. Note any new medicine, supplement, food, pain, fever, or change in bowel movements.

Arrange a GP review if the colour or smell persists, keeps returning, or occurs without an obvious fluid loss. Take a list of medicines and describe the colour rather than relying on a photograph.

Seek urgent care for confusion, fainting, severe weakness, inability to keep fluids down, very little urine, severe abdominal pain, or yellow skin or eyes. Get prompt assessment for blood in the urine, fever with back pain, or dark urine after intense exertion. These features can signal a problem requiring more than simple hydration.

Ask whether you need urine and blood tests, whether dehydration or heat exposure explains the change, and whether liver or kidney checks are appropriate. Mention recent travel, alcohol, supplements, new medicines, pain, fever, and any jaundice.