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What Causes Cloudy Urine? 9 Reasons and Treatments

Tagged in: Urinary Health

by Dr. Bryan Do, D.O. Last Updated: May 14, 2020

What does Cloudy Urine Mean

Ever wondering why is my urine cloudy? If it's just happening once and goes away it isn't too concerning. However, if it's persistently cloudy you should pay close attention to it because your body may be trying to send you a message about your health. Read more to learn the possible reasons for cloudy urine and the treatment options.

Concerning Symptoms with Cloudy Urine

Dysuria - A burning sensation when you urinate
Frequent urination
Flank tenderness - Pain in the lower back which indicates that the UTI has spread to the kidneys
Suprapubic tenderness - Pain in the area above the pubic bone when it is pressed down
Fever - A severe UTI can lead to fever

If you are experiencing any of your symptoms along with your cloudy urine you should see a doctor for proper diagnosis, testing, and treatment.

Causes of Cloudy Urine

1. UTIs

When a person walks into the doctor's office complaining of cloudy urine, the first thing that a doctor is concerned with is a urinary tract infection (UTI). These refer to infections in any part of your urinary tract. Most UTIs affect the lower urinary tract which consist of the bladder and urethra. Women are generally more prone to urinary tract infections due to their anatomy. Women tend to have shorter urethras than men, making it easier for bacteria to travel to the bladder. Common symptoms of a UTI include:

A strong and frequent urge to urinate
Burning or discomfort when urinating
Pain in the pelvis, lower abdomen, or lower back¹²

Cloudy white urine is a common sign of a urinary tract infection, which may also cause a bad smell. Milky urine may also be caused by bacteria, crystals, fat, white or red blood cells, or mucus in the urine. Urine may also appear red, pink, or light brown, which usually suggests blood in the urine.¹²

Along with the general pain and discomfort, urinary tract infections can result in some serious problems, including permanent kidney damage and sepsis. A high fever, nausea, and pain in your upper back and sides is a sign that the infection has spread up to the kidneys.¹² See a doctor immediately if you suspect you have a UTI.

2. Dehydration

Normal urine is clear and has a pale yellow color. If there is cloudy urine with no pain this may be a case of mild dehydration. Young children and the elderly are particularly at risk. Hot weather, intensive exercise, vomiting, diarrhea and fever will also put you at risk.

How much water a day should you drink? The daily 8 cups a day rule is for average healthy people. In general, how much water per day you need depends on the individual. To keep things simple follow these guidelines:

Drink water when you're thirsty.
If you're not thirsty, stop.
During hot weather, intensive exercise, other situations mentioned above, drink more to compensate for the lost fluids.

3. Diabetes

People with diagnosed or not diagnosed diabetes can experience cloudy urine. This is because the kidneys have to process excess sugar in the blood which can cause dehydration. Kidneys damaged with diabetes can also hinder the kidney from filtering urine. If you have cloudy urine and are diabetic, discussing your symptoms with doctor is a good idea.

4. Sexually Transmitted Infections (STIs)

Some STIs will cause body inflammation resulting in excess white blood cells that will cause cloudy urine. Other STIs increase vaginal discharge that will contaminate your urine making it cloudy.

Some other symptoms with STIs include:

Cloudy, smelly urine
Painful or frequent urination
Itchy genitals
Genital discharge
Genital sores.

Thrush, a type of fungal infection caused by Candida albicans, is not classified as an STI, but it can potentially be triggered or transmitted through sex. While it most often affects the oral cavity, thrush may also affect the armpits, groin, genitals, and the areas between the fingers.

Vaginal thrush, also known as vaginal candidiasis, is one of the most common yeast infections. Along with stinging or burning when urinating, vaginal thrush can cause a thick, white discharge that smells yeasty and appears like cottage cheese. Some of this discharge can mix with your urine and potentially cause it to appear cloudy.¹¹

Cloudy urine in itself is not a sign of thrush or a sexually transmitted infection. If you suspect that you have a STI it is important to abstain from intercourse and consult your doctor.

5. Kidney Stones

Kidney stones release a high level of minerals in the urine which cause cloudiness. Many people with kidney stones will have back or side pain, fever, bloody urine, cloudy smelly urine, and burning urination.

Staying hydrated is important in trying to pass smaller stones. If the stones are too big, surgical procedures are available.

6. Prostatitis

An inflamed or infected prostate causes an increase of white blood cells, formation of pus, and discharge. These all can cloud urine.

7. Vaginitis

Vaginitis occurs when your vagina is infected by an organism. Common conditions are yeast infection, trichomoniasis or bacterial vaginosis. The excess white blood cells and discharge can cloudy your urine.

8. Foods That Cause Cloudy Urine

Cloudy, smelly urine may be due to diet. If your urine smells different than usual, it’s not necessarily a bad sign. Sometimes it can be caused by the food you eat. In some people eating asparagus will lead to the production of urine that smells like asparagus. If you’re dehydrated your body will produce a darker, more pungent urine in order to conserve water.

What you eat and drink can also cause cloudy urine. Meals high in calcium phosphate (milk), phosphorus (meats and dairy), and vitamin D can cloud urine.

How Do Different Foods Affect your Urine Color?

Sometimes the food you eat can change the color of your urine and the results may appear alarming if you don’t know the cause.

For example, rhubarb, beets, and blackberries can temporarily give your urine a pink or red hue, which some people may mistake for blood.
If you have been eating aloe or fava beans, then you may notice that your urine is looking a little browner than usual.
Carrot juice, carrots and high levels of vitamin C can turn your urine orange, while B vitamins can make it appear fluorescent yellow-green.

9. Medications

There are a number of over-the-counter and prescription medications that can affect the appearance of your urine. For example:

Orange urine: phenazopyridine (Pyridium), warfarin (Coumadin), rifampin (Rifadin)
Red urine: thioridazine (Mellaril), senna (Ex-Lax), chlorpromazine (Thorazine)
Brown or tea-colored urine: nitrofurantoin (Furadantin), chloroquine (Aralen), primaquine (generic), metronidazole (Flagyl)
Blue or green urine: promethazine (Phenergan), cimetidine (Tagamet), indomethacin (Indocin), amitriptyline (generic)

Is Cloudy Urine a Sign of Pregnancy?

The fluctuating hormones and bodily changes during pregnancy can naturally lead to changes in urine. One of the most prominent changes is an increase in human chorionic gonadotropin (HCG), a hormone that nourishes the fertilized egg after it is implanted in the uterine wall. Home pregnancy tests usually measure for high levels of HCG.¹⁰ However, this hormone generally does not affect the urine’s color or consistency.

That said, pregnant women are more prone to urinary tract infections, which can cause urine to appear cloudy. Consult your doctor if you notice cloudy urine during your pregnancy.

Urine Colors

As urine can reflect your internal health, drastic changes to your urine’s color can be alarming. However, some shades of urine may be caused by food or medication you are taking and shouldn’t be cause for alarm.¹³ Some stranger urine colors you may experience include:

Brown urine – Brown urine is most commonly caused by fava beans, though metronidazole (an antibiotic commonly used to treat a variety of infections) and senna (an over-the-counter laxative) can also cause brown urine.
Light brown urine – Urine that is light brown in color can potentially be an indicator of kidney failure or disease. You may also experience light brown urine after extreme exercise, which can cause rhabdomyolysis. This is essentially a breakdown of skeletal muscle. This can result in a release of excess myogoblin into the blood, which may then result in kidney damage.
Orange urine – The biggest concern with orange urine is liver disease. However, foods high in beta-carotene, like squash and carrots, as well as high consumption of vitamin C can cause urine to turn orange. Rifampicin and phenazopyridine can also cause orange urine.
Red or pink urine – Red or pink shades of urine usually point to bleeding somewhere in your urinary tract. The redder the urine, the more blood present. Pain associated with red or pink urine usually means kidney stones or an advanced UTI. However, don’t be too alarmed if you have recently eaten a large amount of beets or berries, which can also contribute to red or pink urine.
Blue or green urine – High concentrations of B vitamins can turn urine green. A variety of medications, including amitriptyline, propofol, and indomethacin, can also turn urine shades of blue or green. Pseudomonas, a rare hospital infection, can also turn urine blue or green. However, the most common cause of blue or green urine is food coloring.

Dark Cloudy Urine vs. White Cloudy Urine

While dark cloudy urine may appear more alarming, it is almost always a sign of dehydration. Make sure you are taking in enough fluids throughout the day, especially if you are older, more active, and/or live in a hotter climate. White cloudy urine is usually caused by any of the factors discussed above.

Cloudy Urine Prevention

The following lifestyle changes can help improve your urinary health.

1. Drink Water

Drinking plenty of fluids every day is important if you want to keep your urine clear. It will also help you flush your urinary tract more often and lower the chances of developing a Urinary Tract Infection. We recommend drinking enough water so that you are urinating once or twice every 2 hours. This amount differs for everybody because people that work out or sweat more will require more water.

2. Practice Good Restroom Hygiene

Because women are more prone to UTIs, practicing good toilet hygiene is essential. Women should always wipe from front to back to prevent the movement of bacteria towards the urinary tract.

3. Practice Safe Sex

Both chlamydia and gonorrhea are spread through semen, vaginal fluids, and other sexual fluids, meaning that they can easily be prevented by practicing safe sex. Always use a condom or dental dam when having sex, especially with new partners. You should also consider using lubrication when having intercourse, which can prevent irritation and the formation of microscopic tears in your skin that make it easier for bacteria to infect your body.

Because gonorrhea, chlamydia, and other sexually transmitted infections don’t often exhibit any symptoms, make sure to get tested for STDs regularly if you are sexually active with multiple partners. This not only helps you diagnose and treat any potential STIs you have, but also ensures that you don’t spread the infection to your sexual partners. Most STIs (including chlamydia and gonorrhea) are easy to treat and cure with a round of antibiotics.

4. Take a Cranberry Supplement

You can actually reduce the risk of contracting a UTI by creating an environment that is inhospitable to UTI-causing E. coli bacteria. Cranberry binds to receptors on bacteria’s surface, preventing them from attaching to the urinary tract so that it can be flushed from your body.² Cranberry can be obtained from concentrated fruit juice or supplements. Cranberry supplements are more concentrated than juice and do not have the added sugar that cranberry juice does.

D-mannose is a nutritional supplement which has been found to be effective for preventing reoccurring UTIs.³ D-mannose is a simple sugar that is poorly absorbed by the body and is partially excreted in urine. D-mannose works similarly to cranberry in that it helps prevent E. coli bacteria from sticking to the walls of your urinary tract. A study in Brazil found that a 2g daily dose was more effective than the antibiotic nitrofurantoin in preventing reoccurring UTIs.⁴

5. Take Probiotics for Cloudy Urine

A woman’s vagina contains natural bacteria probiotics that help protect against infection. If the balance of these probiotics is upset, it can make a woman more prone to yeast infections, Bacterial vaginosis, and UTIs. The probiotics that normally reside in the vagina can be disrupted through antibiotic use and the act of douching.

To maintain healthy vaginal flora, consuming Lactobacillus probiotic bacteria found in yogurt, kefir, or concentrated probiotic supplements for women, can promote healthy vaginal flora and reduce the growth of bad bacteria that can cause UTIs, yeast infections, and bacterial vaginosis.

Cloudy urine and other changes to the color and consistency of urine can be alarming, and you should consult your doctor if you do experience irregular urine. However, with some lifestyle changes like avoiding wiping from back to front and cranberry, D-mannose, and probiotic supplements to inhibit bad bacteria from occupying the urogenital tract, you can maintain your urinary health and reduce your chance of cloudy urine for good.

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About the Author:

Dr. Bryan Do, D.O.

Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.

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