Urology/Murky white urine
QUESTION: Hi Dr Goldstein,
I have recently went to the emergency room after noticing a few days ago that I felt the urge to urinate, not much came out, and it was white. It was nearly impossible to see through (very murky) and at the emergency room the sample I was able to give was also pretty murky. But, they said the dipstick tests and urinalysis all came back negative.
This seems to happen when I drink a good amount of milk and eat salty foods. Is this some sort of dangerous intestinal/kidney problem? I am a little worried.
I am currently scheduled to see a urologist next week, just hoping to get some information on what tests I should ask for.
ANSWER: Joe, cloudy urine can occur because of consuming large amounts of dairy products (but not salty foods). Milk is high in phosphates which are partially excreted by the urine. Milk also make the urine alkaline which in turns causes calcium phosphate crystals to form in the urine giving it that murky appearance. Mucous, fat, white blood cells (pus cells) & prostatic fluid can also cause this discoloration in the urine. However, something else is going on because discoloration from dairy products will NOT cause urgency with the passage of small amounts of urine. The latter suggests an inflammation of the urinary tract (in spite of your normal urinalysis). The most common cause of your symptoms would be an inflammation of the prostate gland, so called prostatitis.
Your urologist will do a history and physical examination to include a digital examination of the prostate gland. He will also express a few drops of fluid from this gland to examine along doing with a urinalysis. If the diagnosis is prostatitis, he will recommend treatment. This is a very common problem and usually does not require further testing. Good luck.
---------- FOLLOW-UP ----------
QUESTION: Hello Dr Goldstein,
I recently went on antibiotics, and haven't had an urgency problem since. However, the murky urine has not stopped. It always happens it seems, after eating a large amount of cheese. I can drink milk fine it seems without the clarity of my urine changing.
I saw that some time ago you included a macro for someone to read about this phenomenon. If you still have it I would like to see it.
I don't know why this began still, though. I have eaten tons of cheese and drank lots of milk all my life without this ever occurring, so I fear some abnormality that will cause osteomalacia or worse is happening here.
Can phosphaturia like this simply be normal due to intake of food and never affect my bones? I really hope so.
Thank you in advance for your help!
Joe, milk, cheese and dairy products in general can cause phosphaturia. The excess consumed is just being excreted in the urine & not being absorbed from your bones. This in itself will not cause osteomalacia. If you want to check this out further to reassure yourself, get a blood test (metabolic survey) that will check your serum calcium, phosphorous,electrolytes, and a number of other factors. If still concerned, get a dexiscam to check the health of your skeleton. To follow is my "macro"on this topic:
There are many causes for cloudy urine. First, you must understand pH which is the relative acidity of a substance. A pH of 7 is neutral, less than 7 acid and more than 7 alkaline (or basic). The pH of urine is normally acid but can be greatly influenced by what we eat. The most common cause of cloudiness is due to the excretion of alkaline urine which causes urinary phosphates to come out of solution to form semisolids (which is the cloudiness perceived). Carried to extremes, this may be a factor in the formation of certain types of kidney stones but everyone produces alkaline urine periodically. Many foods do this the most prevalent being milk and other dairy products and citrus fruits and drinks. Urinary tract infections (UTIs) can also produce cloudy urine. In this instance, the cloudiness is due to pus cells (white blood cells in the urine). Usually, but not always, there are symptoms suggesting infection such as urinary frequency or burning. A simple urinalysis can usually differentiate the causes. Regardless of etiology, the cloudiness will be more apparent the more concentrated the urine and less apparent the more hydrated the individual. Good luck.