Dark urine & night-time peeing.

[Tempted]

Hi

I've have green and tea / amber coloured pee and not sure what to do, as my doctor isn't being very helpful. I'm a 29 yr old male.

At the end of May 08, I started getting headaches and then twitching in my limbs and visual disturbances � floaters and black circles. At the time, the doctor couldn't think of anything other than stress but thought I had high blood pressure after taking readings during several visits.

I had a 24 hr urine sample taken, a kidney ultrasound, 24 hours blood pressure monitor and blood tests. All came back ok.

In September 08, I started getting backache and side pains and then noticed that my urine was very dark each morning � like Amber.

I went back to the doctors again and he requested another 24 hour urine sample to test for a chemical produced by a cancer. Because of lost test results, a leaky bottle, missing sample etc, its taken since October to the end of July to get the results. Again these are ok.

At the time of my last visit, I explained my headaches had all but stopped and that I'm seeing a lot less floaters in my vision. However, I told him that my urine gets very dark in the day now too despite drinking 3-4 litres of fluid a day, that I have a dry mouth and now get up in the night to use the loo 4 or 5 nights a week, which I never used to. I still have backache most of the time.

I asked the doctor whether it was possible I had diabetes and he said that the test results did not suggest that was the case. I also asked about kidney damage and he again said the test results did not suggest that either.

Firstly, does anyone have any ideas what might be wrong, and secondly how do I get a second opinion from a doctor not working at my regular practice ?

Thanks.

[carlton23]

Firsty, drink plenty of water daily, at least 2 ltrs, secondly, if there are other doctors in the surgery that you attend, ask to see another, you are quite intitled to do so. Good luck.

[Sqad]

Because of lost test results, a leaky bottle, missing sample etc, its taken since October to the end of July to get the results.

I do despair.

I think that you can safely say that the bladder, kidneys are not to blame.
Dehydration is a non starter as you are drinking plenty...probably too much.

Haemolytic anaemia can be ruled out, as the blood tests are normal.

Two things come to mind:

1)Diet
2)Liver disease.

I would ask to see a Consultant General Physician ...privately if necessary.

[deggers316]

i second squads reply.
ask your gp to refer you to a specialist at your local hospital,i know you've had tests done but they go more in depth on your condition.
btw due to triple cases in my family of miss-diagnosis with various gp's in my area i would not rely solely on a gp ,do research on the internet about your prob: as well
good luck,

[LazyGun]

I know that you said that the blood tests came back and were described as normal, but I would just add one other possible cause to sqads list, which is a pretty rare form of haemolytic anaemia, called paroxysmal nocturnal haemoglobinuria, or PNH for short.

Given that you are a young male, the more obvious markers for anaemia that are measured in a standard FBC may not be affected.
I would be inclined to ask about getting something called a Hams test, just to exclude this as a possible cause.

[Sqad]

Lazy.....hope you had a good weekend.

PNH...surely the blood tests would show a haemolytic picture as would the bone marrow, which were all reported as normal?

[LazyGun]

Sqad, I didnt see that he had had a bone marrow test - if he has then yes, that would probably show a hamolytic picture and forget I mentioned it :)

A FBC however - well, I have seen cases of PNH over the years, with an apparently normal count - depending on diet, age, general health etc the more obvious signs of haemolysis, can be masked. If a reticulocyte count has been included and come back normal, then fair enough - but this isn't always included in an FBC.

TBH i think it pretty unlikely, but that comment about very dark urine and back pain etc make it worth just excluding, i would have thought.......

[Sqad]

Lazygun....don't you dare go away again at the weekend, leaving me with all these chemico-pathology problems.

Not my scene..LOL

[Tempted]

Thanks for all your suggestions...

Because I've had a number of test, the other doctors at the surgery just refer any decisions to my GP, who owns / runs the practice. Therefore I guess I'd need to go private for a second opinion, which I'm seriously considering - I just have to go back to the surgery yet again to get my GP to refer me. I'm a professional, level headed bloke but I think he thinks I'm a raving hypochondriac.

Interesting about the liver comment, this all started about 3 weeks after I fainted at a BBQ at which I'd been drinking a lot of Wolf Blass.. about 3/4 of a bottle. That said, I'm not a heavy drinker - I dont binge drink every friday and saturday night.. normally get through a bottle week, sharing two or three bottles. I'd just got over labyrinthitis, which was the first time I'd been ill in 20 years but for the odd cold, so put the fainting down to that. I'm not starting to wonder.

Two blood tests were a little high - cholesterol and liver function, but they said the liver function was only a little high and could be explained if I'd had alcohol the day before the test. I'm due to have those retested soon. I had to give up the gym with the labyrinthitis, and was just getting back into it when the headaches started, so I put on weight I think that didnt help the cholesterol test.

[zzxxee]

i would of said dehydration but you are drinking a significant amount of fluid so this is not the case. I WOULD GET YOURSELF DOWN TO YOUR local hospital a and e if you have to because you really need to sort this out your doctor sounds very incompetent.

[Tempted]

I don't think I've had a bone marrow test... but then they dont explain all the codes on the blood test request.

[factor-fiction]

I would have suggested lack of water but you seem to be taking in plenty of fluids...although it depends on what these fluids are. Is it water?

[Tempted]

I'd say my doctor was experienced and I've found him to be a pleasant guy, but I think theres a degree of bafflement.. he admitted doctors diagnose stress when they cant find out a specific cause for things like headaches and said that applied in my case. I also think theres a degree of arrogance - if the tests come back ok, there simply cant be anything wrong despite the fact I know my own body....

[LazyGun]

You would remember if you had had a Bone Marrow biopsy Tempted - its unusual and can, unfortunately, be painful.

The situation you are in sounds pretty frustrating, especially if you dont feel seeing another GP at your existing surgery would help.

In the absence of any really compelling evidence for a specific diagnosis, in your shoes I would look to rule out PNH.

[Tempted]

Fluids... Well, I've been really quite worried about this, so I've cut right down on alcohol... in last 2 months... a glass or two a week literally, so all my fluid intake is orange cordial or coke zero, with occasional sparking water.

I've just come back from Valencia to see the grand prix, and over 3 days last week...

day 1 ) drank 4 litres of water / coke zero, 1 large glass of wine and pee'd 6 times.

day 2) 4 1/2 litres of water / coke zero, 1 small glass of wine and pee'd 12 times.

day 3) 5 litres of water / coke and pee'd 9 times.

Each night I got up once in the middle of the night to pee.

[Tempted]

LazyGun, you cant imagine how frustrating this is.... although, clearly, I don't want to find out I've got something wrong, and really now I can begin to appreciate how people must feel when they are ill with something serious or unpleasant, the sense of not knowing whats wrong is dreadful..

I can live with the backache and dry mouth and the odd visual disturbance and the dark urine does not affect me other than to make me aware theres possible something wrong... however, all the time this is going on and going untreated, I'm more worried about any lasting damage it may be causing....

[factor-fiction]

I notice you are bracketing the water and coke zero together. Is this mainly water or mainly coke zero? Maybe all that coke zero is affecting your urine..

[Mamyalynne]

Am in no way blessed with any medical knowledge, but I feel 5 Litres of fluid plus what you will get from food is a bit excessive and may in some way be overloading your system??

[Tempted]

The coke and water are about half and half, perhaps it was more water. When I'm at home, I drink 80 - 90% orange cordial the rest is coke zero or sparkling water.

The thing is, if I dont drink enough I get a dry mouth and I've also found the more I drink, the lighter the urine so to try and keep my urine as near to the colour it used to be, I try to drink enough to do that.

[factor-fiction]

I know every time I eat beatroot my urine goes a strange colour. Maybe the orange or coke is having an effect as you do seem to drink rather a lot of these. Have you considered cutting out the coke and orange and drinking only water for a few days to see what impact this has?