Urobilinogen in Urine: High, Low, Causes and Treatments

Urobilinogen is a waste product that is produced when the body breaks down bilirubin by the good bacteria in your intestines. The presence of urobilinogen in urine indicates that there may be certain diseases and conditions such as liver disease or intestinal bleeding. Urobilinogen in urine can cause abdominal pain, nausea, vomiting, and dark stools that are tarry in appearance. In addition, it also occurs in three levels: normal, low, or high.

This article will define urobilinogen in urine, explain its causes, and discuss prevention and treatment options.

Urobilinogen in Urine
Urobilinogen in Urine: Symptoms, Causes, and Treatments

What is Urobilinogen and Urobilinogen in Urine Range

Urobilinogen is a colorless pigment produced by the reduction of bilirubin during the breakdown of hemoglobin in the liver.

The liver filters urobilinogen from the blood. Some go into the intestine, eventually eliminated in the stool, while others are reabsorbed into the bloodstream and excreted in the urine. Urobilinogen is normal in urine; its average level is trace amounts in urine (0.2 – 1.0 mg/dL).

However, urine with little or no urobilinogen may indicate something preventing bile from entering the intestines, while urine with elevated amounts of urobilinogen may indicate liver illness.

What is urobilinogen in urine tests?

Urobilinogen in urine refers to the presence of urobilinogen in the urine after a normal dye-test has been conducted on the urine sample and then dropped into dilute hydrochloric acid or iodine solution.

This test is sometimes carried out in a urinalysis. Your physician may use this urinalysis to discover if different cells, chemicals, and other substances like proteins, ketones, and glucose are in your urine.

In addition, this test, urinalysis, also helps doctors diagnose liver diseases, such as hepatitis or cirrhosis and other medical conditions. The symptoms of liver disease include

  • Nausea and vomiting
  • Lack of appetite
  • Fatigue and Weakness
  • Jaundice and belly pain
  • Swelling in the part of the body
  • Dark-colored urine with/or light-colored poop
  • Frequent itching and child
  • Headache and fever

What are Low Urobilinogen Levels?

Urobilinogen is considered low if it is less than 0.2 milligrams per deciliter (< 0.2 mg/dL). This test result indicates blood flow, bile blockage, or liver problems.

What are the symptoms of low urobilinogen levels?

The main symptom of low urobilinogen level is yellowing of the skin (jaundice). Other symptoms may include dark urine, fatigue, vomiting, itching, anorexia, weight loss, and pale stools.

What are the causes of low levels of urobilinogen?

If you have low urobilinogen levels in your urine, you must talk to your doctor to find the cause and get appropriate treatment. There are several reasons why a person may have low levels of urobilinogen:

1. Reduced bile flow (Cholestasis)

The leading cause of low urobilinogen levels is reduced bile flow, also known as Cholestasis. Cholestasis is the accumulation of bile pigment in the liver, a common cause of low urobilinogen levels in patients with cirrhosis.

Bile pigments are released into the bloodstream as part of bile secretion by hepatocytes. The bile pigment is then transported to the small intestine via hepatic ducts and gallbladder, hydrolyzed to form bilirubin, and excreted in feces. Cholestasis occurs when bile flow from the liver to the small intestine is obstructed.

The most common causes of Cholestasis include blockage of the bile ducts, pancreatitis, pregnancy, hepatocellular carcinoma, severe infection, and liver illness.

2. Certain drugs

Certain drugs like antibiotics can reduce urobilinogen formation by blocking enzymes involved in its production or metabolism.

In addition, drugs that treat diabetes, high cholesterol, high blood pressure, and acerbate urine, like ammonium chloride or ascorbic acid, may interfere with urobilinogen production by your liver or kidneys.

Therefore, taking these medications regularly over time can cause low levels of urobilinogen in your urine.

3. Kidney disease or failure

Kidney disease can cause low urobilinogen levels because your kidneys are responsible for making it. Besides, they can also lead to other problems such as high blood pressure, heart problems, and even death.

4. Strenuous exercise

Some people who exercise strenuously for extended periods may develop lower urobilinogen levels because their bodies use more energy than usual during exercise sessions.

Other potential causes include liver disease, intestinal bleeding, and diarrhea.

How do you increase urobilinogen levels?

The treatment of low urobilinogen levels depends on your specific symptoms.

1. Treatment of the underlying cause

Diagnosis and treatment of the underlying cause of urobilinogen deficiency like Cholestasis, pernicious anemia, and kidney disease will normalize the level of urobilinogen in your urine. So, you must consult your health provider.

2. Quality sleeping time

Having quality sleeping time and eating a well-balanced diet will also help increase urobilinogen in urine. Certain foods such as green vegetables, asparagus, figs, prunes, fiber, healthy grains, and plums are confirmed to increase the amount of urobilinogen in your urine.

They contain natural pigments called flavonoids that interfere with the breakdown of red blood cells. In addition, a high protein diet will also decrease uric acid levels and urea in urine.

3. Drink more water

Staying hydrated by drinking more water will increase urobilinogen in your urine. Also, reducing stressful activities or routines will increase your urobilinogen level.

This will help lower your blood pressure, minimize kidney stress, and improve your kidney function.

4. Lose weight

Losing weight is another meaningful way that helps with urobilinogen levels. The body has a metabolic equilibrium that must be maintained; it means you need the energy to digest food and excrete waste products.

If you are obese or have a high BMI, it may be harder for your body to maintain proper uric acid levels, which may affect your blood’s uric acid level. If you lose weight, you will be more efficient at metabolizing calories and thus waste less energy in digesting food and excreting urobilinogen.

5. Avoid alcohol

The urobilinogen in your urine can increase if you avoid alcohol. Alcohol is a diuretic and increases uric acid production. Therefore, drinking alcohol could increase your blood’s elevated uric acid level. If you are trying to lower your uric acid level, avoid drinking alcohol altogether or limit how much you consume daily.

6. Take Vitamin B12

Administered vitamin B12 supplements orally or sublingually (under the tongue) is another way to improve the urobilinogen in your urine.

High Urobilinogen levels
High Urobilinogen levels

What are High Urobilinogen levels?

Urobilinogen is considered high if it is more significant than 1.0 milligrams per deciliter (>1.0 mg/dL). This kind of test result indicates a sign of liver or kidney disease.

What are the symptoms of high levels of urobilinogen?

If you have a high level of urobilinogen in your urine, it may be a sign of liver or kidney disease.

Symptoms of liver disease can include:

  • fatigue
  • loss of appetite
  • back pain
  • fever
  • nausea or vomiting
  • Tachycardia (rapid heart rate)

Additional symptoms depending on the specific cause of the liver problem may also include:

  • jaundice (yellowing skin and eyes)
  • redness of palms or soles of feet
  • itching all over the body,
  • darkening of bowel movements to black color
  • light-colored stools with floating yellowish particles
  • anemia

What are the causes of high urobilinogen levels?

1. Liver disease

One possible cause of high levels of urobilinogen in urine is liver disease. The liver is a vital organ that plays an important role in bile production, which is essential for the digestion of fats and proteins.

If a patient has liver problems, the bile ducts will not be able to transport bilirubin from the blood as quickly and efficiently as expected. This can result in high levels of bilirubin in the blood and urine.

2. Kidney problems

The leading cause of high urobilinogen levels is kidney disease (nephropathy). The kidneys’ purpose is to filter the waste products from the blood before the liver removes them and excretes them through urine.

If your kidneys do not work correctly, they lose their ability to filter waste products from your body, leading to high levels of urobilinogen in your urine sample. You may also have an increased risk of developing kidney damage when taking certain medications or if you drink too much alcohol regularly.

3. Broken red blood cells

Another possible cause for high levels of urobilinogen in urine is when red blood cells are broken down. As red blood cells break down, they release hemoglobin which contains iron.

The hemoglobin then enters the bloodstream, which may break down into heme molecules that produce a dark pigment called hemosiderin that will turn the person’s pee brownish-red.

4. Malaria

The presence of urobilinogen in the urine is a sign of malaria. This condition is caused by the parasites that attack red blood cells. Urobilinogen levels rise as the parasites multiply, and this increase can be detected if an appropriate test is used to see it.

The presence of urobilinogen in the urine can also be detected during blood tests for certain types of cancer, such as leukemia, lymphoma, and myeloma, when it indicates that these diseases have spread from the bone marrow to other parts of the body.

5. Cirrhosis

Another possible cause for the high presence of urobilinogen in the urine is cirrhosis. Cirrhosis usually causes an enlarged liver and varicose veins in the esophagus.

A person with cirrhosis will have trouble digesting food because their liver no longer works correctly. They might also have problems breathing from fluid built up around their lungs or fluid buildup in their abdomen (ascites).  People with this condition risk developing liver failure, which can lead to death.

6. Pernicious anemia

Pernicious anemia is a rare but severe condition in people with a genetic mutation that prevents their body from breaking down the B vitamin thiamine. This can lead to severe nerve damage, including loss of vision and control of bodily functions. The ailment can be fatal if not treated promptly.

7. Gastritis

Gastritis can cause high urobilinogen levels in some people because it narrows the small intestine, which leads to higher absorption of urobilinogen from food into the bloodstream.

8. Tumors or inflammation

The last two causes of high levels of urobilinogen in urine are tumors or inflammation in the colon or rectum. Tumors or inflammation in these areas can increase the amount of blood flowing through them, leading to more hemoglobin loss.

How to Treat High Urobilinogen Levels?

1. Exercise

Exercise is an excellent way to reduce urobilinogen levels in urine. Physiologically, exercise increases the kidneys’ activity, making it easier to eliminate waste from the body.

Physically active people tend to have lower levels of urobilinogen in their urine than those who are not because of regular exercise.

In addition, exercise also increases the production of urine by the kidneys, which means that more urobilinogen will be excreted into your urine. So if you’re looking for a way to reduce your urobilinogen level without taking medications or other supplements, exercise may be just what you need!

2. Reduce Stress

Stress can have an impact on your body’s ability to produce urobilinogen. Stress contributes to increasing appetite, which leads to weight gain and obesity.

Reducing stress will help reduce the amount of urobilinogen produced in your body. You may consider taking up meditation or other calming activities like yoga or tai chi as hobbies or just for stress relief at home or your workplace.

3. Eat More Fibrous Foods

Fiber helps you feel full after eating. So eating foods with high fiber content will reduce hunger pangs by slowing down digestion and keeping you fuller longer between meals. Consume high-fiber foods like whole grains (brown rice and quinoa), fruits, and vegetables to reduce urobilinogen levels in your urine.

4. Stay Hydrated

Staying hydrated is essential in helping your kidneys get rid of urobilinogen. This will also help keep you fit and prevent constipation. To stay hydrated, drink plenty of water throughout the day. If you don’t feel as thirsty, it may be because you’re not drinking enough water (or your body isn’t telling you that it needs more).

5. Treat underlying ailments

If you have a condition causing high urobilinogen levels, such as diabetes, cancer, and so on, talk to your healthcare provider about how these conditions impact urination and dehydration.

You may need to adjust your treatment plan or take medications differently depending on what caused your high urobilinogen level. In addition, some medicines can cause dehydration or increase urination frequency if used at certain times of the day, with certain foods or drinks.

6. Review your medications

Look at all prescribed medications you take and see if any could be causing an increase in urination frequency or volume (such as diuretics). If so, talk to your doctor about adjusting the dosage or adding another medication. Take caution with some of these drugs:

Ephedra, Phenothiazines (such as chlorpromazine), Paracetamol (Tylenol), Non-steroidal anti-inflammatory drugs, Methyldopa, Amiodarone, Sodium valproate, Monoamine oxidase inhibitors, Oral contraceptives, Chaparral leaf, Germander, Kava, Senna, Vitamin, EGCG, Gentian, and Aspirin

7. Limit alcohol consumption

Alcohol increases uric acid production, and a high uric acid level is linked to gout. Alcohol also increases stomach acidity, which can lead to ulcers and damage from high uric acid levels. If you have gout or are at risk of developing it, limit your alcohol consumption.

The liver needs iron to metabolize bilirubin, so it is necessary for people with high urobilinogen levels to take more than usual amounts of iron supplements.

However, suppose you do not take any iron supplements. In that case, your body will not be able to metabolize bilirubin efficiently, and cholesterol will accumulate in your blood vessels and other organs such as your brain or heart. This will lead to further damage and complications like heart disease or stroke.

8. Treat Liver problems

Liver disease is another common cause of high urobilinogen levels. So it’s advisable to consult your doctor if you discover you have the symptoms of liver disease.

9. Have a quality sleep period

Quality sleep is vital for the liver to function well. An observational study of close to seventy thousand adults validated that short sleep duration and poor sleep quality significantly increased the prevalence of non-alcoholic fatty liver disease (NAFLD).

10. Drink more coffee

Coffee has plenty of benefits. But did you know that one of those benefits is reducing the amount of urobilinogen in your urine?

Coffee contains a compound called xanthine, which helps eliminate bilirubin from your system. So if you want to reduce the amount of urobilinogen in your urine (without having to go on any medications), drink more coffee!

11. Meet your doctor on how to reduce Urobilinogen

If you are concerned about the level of urobilinogen in your urine, make an appointment to see your doctor. He may want to run some tests to rule out any underlying medical conditions.

If no underlying condition is found, you can do a few things to help reduce the level of urobilinogen in your urine. You should exercise, drink lots of fluids, eat more fibrous food, and refrain from drinking alcohol.

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