Hematuria: What Causes Blood in Urine?

April 2, 2018

What is hematuria? - Dr. Axe
Has your urine ever been brownish or red? If so, you may have already experienced hematuria. What is hematuria? To simply define hematuria: it’s the presence of blood in the urine.

Blood in the urine can originate at any point along the urinary tract from the kidneys to the urethra. Some possible causes of hematuria can include a urinary tract infection, intense exercise and kidney stones, just to name a few. (1) Cystitis with hematuria occurs when the bladder becomes inflamed and blood is present in the urine. Most of the time, this is caused by a urinary tract infection, or UTI. (2) Sometimes the cause of hematuria is not very serious at all. But other times, it can be a symptom of a very concerning health issue. Either way, it’s definitely not something to ignore.

Hematuria is not something I recommend self-treating. But there are a lot of natural remedies for the possible health concerns that can be at the root of it. So what does hematuria mean? Hematuria is not a condition, but rather a symptom of something else going on in the body. Let’s talk more about the underlying causes of it and their natural treatment options. Hopefully your urine doesn’t visibly or unknowingly contain blood. But if it does, there are natural things you can do to help yourself.


What Is Hematuria?

The medical hematuria definition: the abnormal presence of red blood cells (RBCs) in the urine. When you have hematuria, your kidneys or another component of your urinary tract are permitting blood cells to seep into your urine.

There are actually two main types of hematuria. The first is microscopic hematuria. This type of hematuria means that there are red blood cells in your urine, but in such a small amount that a microscope is required to actually see them. Microscopic hematuria is often discovered by accident. For example, when someone gets a yearly physical and provides a urine sample the urinalysis may reveal microscopic hematuria.

When someone has microscopic amounts of blood in urine, the severity of hematuria is measured as red blood cells (RBC) per high power field (HPF) under the microscope. Usually, greater than three to five RBCs per HPF is considered an abnormal result. When the severity is over 20 RBCs per HPF, then a substantial urological or medical issue is likely causing the hematuria. (3)

The second type is macroscopic, or gross, hematuria. This blood loss in the urine can be seen with the naked eye. Someone who has gross or visible hematuria can have anywhere from one milliliter to one liter of blood in the urine. The color does not reflect the degree of blood loss. (4)

There is also a health condition called loin pain hematuria syndrome (LPHS). This involves long-term or reoccurring pain in the loin area accompanied by the presence of blood in the urine. People suffering from LPHS may also experience painful urination, nausea, vomiting and/or a a low-grade fever. (5)


Hematuria Signs & Symptoms

How can you tell if you have hematuria? If you have microscopic hematuria, then you actually won’t be able to tell since the blood in your urine can only be seen with a microscope. However, if you have gross or visible hematuria then you will definitely be able to tell.

Common visible hematuria symptoms include having orange, pink, red, dark red or cola-colored urine. It only requires a very small amount of blood to cause urine discoloration. It’s typical for a change in urine color to be the only sign or symptom since it’s most common to have a case of painless hematuria. However, if you are also passing blood clots in your urine, then this can be painful. (6)


Hematuria Causes & Risk Factors

There are quite a few health conditions that can lead to hematuria. For some, most often elderly people, microscopic hematuria can be the only sign that they have some type of illness or infection. This is just one reason why a yearly physical that includes a urine sample is a good idea for people of all ages.

Hematuria causes can include: (7)

  • Urinary tract infections (UTIs)
  • Kidney infections
  • Kidney disease such as glomerulonephritis
  • Bladder or kidney stones (both can cause microscopic or gross bleeding)
  • Kidney injury
  • An enlarged prostate gland
  • Kidney, bladder or prostate cancer (when there is visible urinary bleeding). However, in the early stages of these cancers there may be no symptoms.
  • Sickle cell anemia
  • Alport syndrome (an inherited disorder like sickle cell anemia)
  • Certain medications such as the chemotherapy drug cyclophosphamide (Cytoxan), penicillin and some anticoagulant (blood thinning) drugs.

It’s not common yet it is possible for very intense exercise to cause gross hematuria. Runners are the most common athletes affected, but it can happen to anyone who takes part in especially strenuous exercise. Why can this happen? Experts believe it most likely occurs as a result of dehydration, bladder trauma or red blood cell breakdown due to lengthy aerobic activity. This phenomenon is sometimes called “sports hematuria.”  According to researchers, sports hematuria typically has a “benign self-limited course,”  but it’s still important to rule out any other causes. (8)

Acute cystitis with hematuria can also occur. This is a a sudden inflammation of the bladder, usually caused by a bacterial UTI. (9)

It is possible for anyone of any age, young or old, to have hematuria. However, there are some risk factors that can make the presence of red blood cells in the urine more likely to occur: (10)

  • Age (and sex): A lot of men over the age of 50 sporadically experience hematuria because they have an enlarged prostate gland.
  • Sex: Over half of all females will have a UTI at least once in their lifetime. These UTIs may or may not include urinary bleeding as a symptom. White males have the highest risk of  kidney stones,which can cause blood in the urine.
  • Athletes: As discussed in hematuria causes, really intense exercise, like long-distance running, is more likely to lead to exercise-induced hematuria.
  • Family history of kidney disease or kidney stones.
  • A recent infection: For hematuria in kids, kidney inflammation after a viral or bacterial infection is one of the top causes.
  • Certain medications: For example, antibiotics (like penicillin) and NSAIDs can raise the risk of urinary bleeding.
Hematuria causes & risk factors - Dr. Axe

Conventional Treatment

If you can clearly see that your urine is orange, pink, red or dark reddish brown in color, then your doctor may not order any additional tests to confirm that you have hematuria. Even if your urine suddenly goes back to looking normal, it’s still recommended that you see a urologist for an evaluation. If you have blood in your urine, then your doctor will most likely conduct a physical exam and run some additional tests including urine tests, imaging test and/or a cystoscopy. (11, 12)

Similar to blood in stool, there is no specific conventional treatment of hematuria. Like seeing blood in your poop, seeing blood in your urine is a symptom of something else going on in your body. Since it’s possible for some serious health concerns to cause hematuria, it’s always a good idea to see your doctor. When you see your doctor for hematuria, they can conduct testing that can hopefully get to the root of the problem. (13)


4 Natural Treatments of Hematuria Causes

Here are some of the natural ways to approach several of the possible underlying causes of hematuria.

If your hematuria is caused by:

1. Urinary Tract Infection

A urinary tract infection is a very common cause of hematuria. Thankfully, there are a lot of natural home remedies that can help a UTI and its resulting symptoms such as blood in the urine. One of the primary ways to help a UTI is to urinate often. Studies show that holding urine for a lengthy amount of time permits bacteria to grow and multiply within the urinary tract. This can lead to a urinary tract infection. (14) The next and somewhat related natural remedy is to stay hydrated! When you have a UTI, you want to be flushing that bacteria out. So make sure you’re drinking enough water and urinating as needed.

Another beverage that can help with UTIs is cranberry juice, but make sure that it is unsweetened. Research points towards cranberry juice decreasing the number of UTIs a person develops over the course of a one year time period, especially for women who struggles with recurrent UTIs. (15) Eating fermented foods, which are rich in probiotics, and taking a probiotic supplement are also really helpful because they put the good flora into the body to help bad that bad bacteria that causes a UTI.

For more ideas, check out: Top 12 Natural Home Remedies for UTI.

2. Enlarged Prostate Gland

For men, an enlarged prostate gland is more likely to be a problem as they get older. Since the prostate wraps around part of the urethra, where urine passes through, an enlarged prostate can lead to urination issues as well as hematuria. In a study published in Nutrition Research and Practice, pumpkin seed oil was shown to decrease enlarged prostate symptoms within a three-month timespan. (16)

Maintaining a healthy weight and regularly exercising also can really boost prostate health. Limiting caffeine and alcohol while increasing intake of healthy fats, such as omega 3 fatty acids, can also be helpful.

3.  Kidney Stones

If you want to avoid or help treat your kidney stones naturally, then there are several foods you’ll want to avoid or reduce as much as possible. These foods include ones high in oxalic acid (things like spinach, rhubarb, tomatoes and peanuts), caffeinated beverages, grapefruit juice, processed factory farm meats and conventional dairy products. Following a plant-based diet with lots of magnesium-rich foods and high-quality water can help decrease the likelihood of kidney stones. Hot water with lemon juice is a great daily drink for kidney stone sufferers. Choosing sprouted grains as opposed to refined grain products is also a good idea to reduce your intake of phytic acid, which is an anti-nutrient.

For more natural remedies for kidney stones, you may want to read What’s Causing Your Kidney Stone Symptoms? Plus 5 Remedies That Work.

4. Bladder Cancer

According to the American Cancer Society, hematuria is typically the first sign of bladder cancer. This doesn’t mean that all cases of hematuria mean someone has cancer, but is is common for bladder cancer to reveal itself in the early stages with blood in urine, but little to no pain or additional symptoms. (17)

Many scientific studies have pointed towards Frankincense (Boswellia serrata) oil as a potential natural treatment for cancer . One study in particular found that frankincense oil appears to activate pathways that lead to bladder cancer cell death. The study concludes that “frankincense oil might represent an alternative intravesical agent for bladder cancer treatment.” (18)


Precautions

If you see blood in your urine, always contact your doctor immediately. Even if it stops, you should still seek a medical evaluation.

It is important to note that eating beets can temporarily change the color of your urine to a pinkish or reddish color. Other foods that can cause temporary urine discoloration when consumed include blackberries, rhubarb, blueberries, fava beans, paprika, and artificial food colorings.

Certain medications can also cause a red pigmentation of the urine. Some of these drugs include: rifampin, sulfonamides, nitrofurantoin, metronidazole, prochlorperazine, phenytoin, quinine, phenolphthalein, levodopa, methyldopa, adriamycin, desferoxamine, chloroquine and phenazopyridine. (19)

If you’re a woman, it’s also normal to see blood in the urine during menstruation.


Final Thoughts

Seeing blood in your urine can be really alarming and it’s definitely not something to ignore. Sometimes, it may just be that you forgot you ate something last night that can affect the color of your pee. Or perhaps, you were unaware that you are currently taking a medication that can cause the discoloration. Other times, there may be a more serious root cause.

No matter the underlying issue, there are a lot of helpful natural remedies for the range of health concerns that can lead to hematuria. Again, it’s important to note that hematuria is not a condition, but a symptom of something else going on in your body.

Read Next: Poop: What’s Normal and What’s Not

 


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