TCM #12: Examine Your Urine

Under normal circumstances, an individual usually urinates four to six times during the day; it is considered normal to get up once during the night. The amount of urine is about 1.5 ~ 2 L /day. The frequency and amount of urination can vary according to our drinking habits, temperature, amount of sweat produced and age. By checking our urination daily, we can learn about not only the state of our body fluids, but also the state of the organs involved in this process. Let’s see how TCM interprets certain urine qualities listed below:

Nature of Urine

• Deep yellow urine can indicate heat accumulation.
• A strong smell of urea may be due to hyperactive heat in the heart and bladder.
• Cloudy yellow urine with a foul odor is mainly due to damp heat pouring down in the bladder.
• Clear, odorless and profuse urination pertains to a deficiency cold syndrome.
• Clear and profuse urine in an exogenous febrile illness means the evil has not yet entered the interior part of the body.
• When the urine turns clear in febrile illnesses, it indicates an individual will recover soon.
• Red urine means the blood stream and the meridians are impaired by heat evils.

Volume of Urine

• Profuse, clear urine and polyuria (excessive passage of urine) at night are due to insufficiency of kidney yang.
• Diabetes is a disease characterized by excessive thirst and polyuria.
• Scanty, yellow urine can be caused by excessive heat, over sweating, vomiting and diarrhea due to the over consumption of body fluids.
• Scanty urine accompanied with edema (general swelling) can be seen inyang deficiency of the lungs, spleen or kidneys; because, the organs are unable to vaporize body fluids and cause water-dampness retention.

Urinary Frequency

• Frequent urination with a large amount of clear urine is due to kidney qi failing to consolidate urine in the bladder.
• Frequent urination, urgency with a small amount of deep-yellow urine or even with bloody or painful urination is due to damp-heat in the bladder.
• An increase in nocturnal (night) urination with clear urine is seen in late stage kidney disease or aged people where the kidney-yang fails to control the urine excretion.

Urine Retention

• In the elderly, if the bladder is distended but unable to void or only excrete a few drops, this is due to kidney-qi deficiency.
• In pregnant women, inhibited urination is usually due to qi deficiency in the middle burner, which causes the fetus to press down on the lower part of the bladder (located in the lower burner region) and resulting in difficult release of urine.
• Inhibited urination after delivery is usually a result of blood stasis or swelling of the uterus, which causes pressure on the bladder and urethra.