Brown wee - hepatitis or running too much?

[partjfos]

Hi, maybe somebody can help to diagnose my condition.  I realise I will probably need tests at a doctors to diagnose accurately but they're expensive and I want to try and best guess what it is I might have, so I can get that test first, and so on.

 

I have had brown wee on 3 separate occasions, at least a week or two between each time.  It's just one visit to the toilet, not a thing that lasts all day.  Just before the first time I was also severely fatigued for about one week, this was when I first suspected something was wrong, I went from sleeping a normal 8 hours or so to more like 13-15 hours.  It was very noticeable fatigue.  The fatigue has not returned since then (that was about 2 months ago).

 

I understand fatigue and brown wee are two classic hepatitis symptoms.  I have had unprotected sex with too many people, and I also sometimes drink untreated water high up in the mountain streams (lazy to carry bottled water so far).  So I went to the red cross centre and got the hepatitis B test which was negative.  I understand there are also A, C, D and E tests but you cannot have D without also having B.  So I could still have A, C or E.  A doesn't sound that serious and goes away by itself after a month or two, so I'm only really worried about C and E.  C seems more prevalent, so would it be sensible to get the C test first?

 

To complicate matters I also run a lot, and I push myself I think more than your average person, I'm not a professional athlete by any stretch but I regularly place inside the top 10 in 10km-70km races in Thailand.  Brown wee can be caused by Rhabdomyolysis - muscle breakdown from exerting yourself too much which can cause serious liver problems?  That wouldn't explain the severe fatigue I experienced but maybe that was a separate bacterial infection or something else not related.

 

I run barefeet which might cause hemolytic-anemia but this should turn your wee red (because of the blood) not brown?  Is the red obviously red i.e. bright red similar to a blood colour, or could it be confused as brown?

 

I also read that Rhabdomyolysis can be caused by viral infections such as HIV and Herpes.  I have herpes.  Also it can be caused by insect bites or snake bites - I'm regularly in the jungle and get bitten by insects, leeches and ticks a lot.

 

I've just assimilated myself with rhabdomyolysis today and it seems serious with most people saying get to the doctors (or even the emergency room) the same day if you exhibit symptoms..?  Is the red cross centre an okay place to go for this because it's not necessarily linked to an STD?

 

Apart from the initial fatigue and the brown wee, I feel absolutely fine.  No nausea or dizziness or anything else.

 

Can anybody make sense of all that and offer their best guess or any other possible causes?

[Kinnock]

There's a real expert on TV - so I'll leave any medical advice to the experts - but as a runner I can add some extra observations ....

 

1. Stop worrying so much - you suggest a range of possible causes, which suggests you've been doing some research, but the more you Google medical issues, the more symptoms you start to feel.  Leave diagnosis to the experts.

2. As you say - dehydration is a likely cause - drink more water ..... much more ..... running in heat causes a lot of water loss.

3. Start to use some sensible precautions in your sex life - there's no point running barefoot to stay fit, if you also go bareback!

Edited June 20, 2018 by Kinnock

[lopburi3]

Although likely not the case you also need to rule out bladder cancer, especially if you have ever smoked - at least have a simple ultrasound exam which is not expensive.  I say this having had this condition several years ago and having delayed hoping it was just exercise blood.  

[phetphet]

Dehydration?

 

[partjfos]

Thanks guys.

 

I thought dehydration just made the urine turn dark yellow or orange.  This is a definite brown.

[jakestevernson]

Pay your money and get checked out properly. No point in trying to save money when it comes to your health.

Sent from my Moto G (4) using Tapatalk

[Justfine]

Don't guess. You could drop dead. Go get checked up. $ is nothing when you are not alive.

[Sheryl]

Dehydration is the most common cause of dark urine and the fact that it is not continuous but just on occasion would further suggest that.

 

I suggest you start by being sure to take in enough fluid -- and be more moderate in your exercise. Regular exercise is fine but going to extremes with it is not,

 

If despite adequate hydration and more moderate exercise the  brown urine recurs or persists then the following tests would be indicated:

 

urinalysis

AST/ALT

serum bilirubin

Hep A antigen

Hep C antibody

creatine kinase

serum creatnine

serum myoglobulin

serum potassium

 

And if any of these come back significantly abnormal then see a doctor, what type of doctor will depend on what the tests show

 

 

 

[partjfos]

I went for a general checkup today, which included the urinalysis and ast/alt as suggested by sheryl.  I found a good deal on metrodeal website - 990 baht for 13 tests, usual price 2500, at bangpakok 1 hospital. Metrodeal take paypal as well, it seems similar to groupon.

 

Results were all fine except ast which was 41 (normal range is 0-40). Alt was 35. Doctor said this could be due to alcohol or drugs/medicine or lack of sleep and not to worry because it was only slightly over. I slept fine and dont drink or take drugs/medication. I looked online later and high ast can also be caused by intense exercise... i did a half marathon the day before...

 

Is 41 worth worrying about?

[Tacuisse]

7 minutes ago, partjfos said:

I went for a general checkup today, which included the urinalysis and ast/alt as suggested by sheryl.  I found a good deal on metrodeal website - 990 baht for 13 tests, usual price 2500, at bangpakok 1 hospital. Metrodeal take paypal as well, it seems similar to groupon.

 

Results were all fine except ast which was 41 (normal range is 0-40). Alt was 35. Doctor said this could be due to alcohol or drugs/medicine or lack of sleep and not to worry because it was only slightly over. I slept fine and dont drink or take drugs/medication. I looked online later and high ast can also be caused by intense exercise... i did a half marathon the day before...

 

Is 41 worth worrying about?

No. There is a margin of error in all these tests, and your result is only one unit above the normal range. Start worrying when it is 50 or 60.

[Sheryl]

41 is fine. Did they check the other tesrs?

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[catman20]

prostate ?

[helloagain]

For gods sake you cheap charlie. I would not play russian roulette with my life. Go straight to international or fly home and find out within 2 hours of being at a hospital exactly what is wrong with you. What looks brown to you might be blood but very weak. Bladder cancer ? And so i could go on. Be cheap but not with your life. Urine test 2 to 3000 baht with their fees included. Or your life.......der

Edited June 26, 2018 by helloagain
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[soistalker]

When you say Brown, I think dark yellow urine with blood in it. If that's the case, it's not serious. 

But with all due respect, what's wrong with you having multiple sex partners in Thailand without using condoms? That's f%&king not smart.

[nauseus]

Well if you feel fine then hepatitis is rather doubtful. With that you feel like sh*t. Here are the main symptoms after it develops into a bad case< when the real giveaway is the white <deleted>!!:

 

muscle and joint pain
a high temperature (fever)
feeling and being sick
feeling unusually tired all the time
a general sense of feeling unwell
loss of appetite and weight
abdominal pain
dark urine
pale, grey-coloured poo (white)
itchy skin
yellowing of the eyes and skin (jaundice)

 

Yes I had all the above!

Had to stop drinking for a year.

Good luck.

 

 

[thaipo7]

I can tell you it is not hepatitis.   I had it there in 1978.  You would be very weak, yellow eyes where the whites are and a yellow tinge to your skin.  You would be scratching you side where the liver is.

[Catoni]

   There are 79 conditions associated with dark colored (brown) urine and fatigue.  These can be either direct causes... or.....  indirect ..and only secondary causes...   Good luck...     Make sure you are drinking enough clean water each day to flush your system.  Dehydration and eating too little fresh fruits and vegatables is another possibility

 

   Possible causes:    Obviously probably only one of these is the cause...  all others can be ignored...  but which one is it ? ?...  we don't know until you get the tests. 

• Hepatitis A

  Hepatitis A is an inflammation of the liver. Symptoms include fever, fatigue, yellowing of the skin, and more.

• Hepatitis B

  Hepatitis B is an inflammation of the liver that may cause fever, fatigue, dark urine, jaundice, and more.

• Hepatitis C

  Hepatitis B is an inflammation of the liver that may cause yellowing of the skin and eyes, tiredness, and more.

• Dehydration (Children)

  Dehydration, or not getting enough fluid, causes dry and sticky mouth, tearless crying, and more in children.

• Thalassemia

  Thalassemia is a rare group of genetic blood disorders effecting red blood cells and leading to anemia.

• Medication reaction or side-effect

  Medication side effects include nausea, vomiting, stomach upset, weakness, dizziness, seizures, and more.

• Multiple sclerosis

  Multiple sclerosis is a disease of the nervous system causing difficulties with balance, speech, and movement.

• Anemia

  Anemia, a lack of red blood cells, can cause fatigue, pale skin, weakness, dizziness, headache and more.

• Mononucleosis

  Mononucleosis is a viral infection causing extreme fatigue, sore throat, fever, rash, muscle aches, and more.

• Depression (Adult)

  Depression is a painful sadness that interferes with daily life and includes hopelessness, anxiety, and more.

• Hay fever

  Hay fever, an allergic reaction to outdoor pollens and molds, causes nasal congestion, itchy eyes, and more.

• Heart rhythm disorder

  Some heart rhythm disorders can cause a fluttering in the chest, shortness of breath, chest pain or dizziness.

• Acute sinusitis

  Acute sinusitis, an inflammation of the sinuses, causes sinus pain and tenderness, facial redness and more.

• Diabetes, type 2

  Diabetes can make you feel hungry, tired, or thirsty; you may urinate more than normal and have blurry vision.

• Sleep deprivation

  Sleep deprivation occurs when the lack of restful sleep is severe enough to compromise basic body functions.

• Taking vitamin supplements

  Taking vitamin supplements can cause upset stomach, diarrhea, unpleasant taste, and changes to urine color.

• Acute stress reaction

  Acute stress reaction symptoms include shortness of breath, anxiety, nervousness, sense of doom and more.

• Viral syndrome

  Viral syndrome is an unidentified cause of typical virus symptoms sore throat, stuffy nose, aches and more. 

• Sleep apnea

  People with sleep apnea stop and restart breathing multiple times while sleeping. 

• Chronic sinusitis

  Chronic sinusitis, or sinus infections, cause a stuffy or runny nose, tooth pain, fever, sore throat and more.

• Cystic fibrosis

  Cystic fibrosis is an inherited disease that causes the body to produce abnormally thick and sticky mucus. 

• Atrial fibrillation

  Atrial fibrillation is a heart condition that causes heart palpitations, confusion, dizziness and more.

• Eating disorder

  People with eating disorders have extreme and dangerous eating habits. 

• Emphysema

  Emphysema is a chronic lung condition that causes shortness of breath, a chronic cough, wheezing, and more.

• Glomerulonephritis

  Glomerulonephritis is a type of kidney disease and causes swelling, abnormal urine, fever, achiness, and more.

• Heat exhaustion

  Heat exhaustion causes intense thirst, heavy sweating, pale, cool, and moist skin, muscle cramps, and more.

• Diabetes, type 1

  Diabetes can make you feel hungry, tired, or thirsty; you may urinate more than normal and have blurry vision.

• Low blood pressure (hypotension)

  Low blood pressure, or hypotension, can make you feel lightheaded and dizzy

• Lyme disease

  Lyme disease is a bacterial infection spread through tick bites; symptoms include rash, fever chills, and more.

• Mumps

  Mumps is a contagious viral disease that causes painful swelling of the glands that produce saliva. 

• Pre-leukemia (myelodysplastic syndrome)

  Myelodysplastic syndromes are diseases that affect the bone marrow and blood, causing anemia and tiredness. 

• Pulmonary hypertension

  Pulmonary hypertension can cause shortness of breath, a fast heart rate, or lightheadedness.

• Rheumatoid arthritis

  Rheumatoid arthritis is an autoimmune disease that causes pain, swelling, and joint damage.

• Tuberculosis

  Tuberculosis usually infects the lungs, causing a bad cough with blood, chest pain, fever, chills, and fatigue. 

• Chronic fatigue syndrome (CFIDS)

  Chronic fatigue syndrome is a condition that causes extreme tiredness that doesn't get better with rest.

• Congestive heart failure

  People with congestive heart failure can have shortness of breath, fatigue, irregular heartbeat and more.

• Depression (Child and Adolescent)

  Depression is a painful sadness that interferes with a child's schoolwork, family life, and social activities.

• Gastrointestinal bleeding

  The symptoms of gastrointestinal bleeding include black or bloody stool or vomit, dizziness, and cramping.

• Hyperthyroidism

  Hyperparathyroidism can cause fatigue and weakness, increased thirst, impaired thinking, and bone fractures.

• Iron poisoning

  Iron poisoning causes abdominal pain, vomiting, diarrhea, lethargy, and dehydration.

• Low blood sugar (hypoglycemia)

  Low blood sugar, or low glucose levels, causes shakiness, anxiety, clammy skin, irritability, hunger, and more.

• Lung cancer (non small cell)

  Non-small cell lung cancer is the most common type of lung cancer and can cause a cough, chest pain, and more.

• Cocaine withdrawal

  Cocaine withdrawal may cause feelings ranging from anxiety, irritability and sleepiness to suicidal thoughts.

• Exercise or physical activity

  Exercise is vital for good health, but overdoing it can lead to muscle aches, dehydration, headache, and more.

• Underweight

  Being underweight means weighing less than you need for good health.

• Bipolar disorder

  Bipolar disorder causes extreme mood swings between depression and mania. 

• Myasthenia gravis

  Myasthenia gravis is caused by abnormal immune responses that weaken muscles, particularly of the face.

• Aortic regurgitation

  Aortic regurgitation, when the aortic valve doesn't close completely, can cause severe heart symptoms.

• Pleural effusion

  Pleural effusion is buildup of fluid in the pleura and can cause difficulty breathing or chest pain.

• Rectal cancer

  Rectal cancer appears in the rectum and causes bloody stool and constipation.

• Dementia in head injury

  Dementia resulting from a head injury may cause memory problems, difficulty speaking, and personality changes.

• Hypothyroidism (adult)

  Hypothyroidism your body functions slow down, making you gain weight and feel tired all the time. 

• Lung cancer (small cell)

  Small cell lung cancer is the least common type of lung cancer and can cause a cough, chest pain, and more.

• Anemia, chronic disease

  Anemia of chronic disease (ACD) can cause fatigue, pale skin, weakness, dizziness, headache and more. 

• Histoplasmosis

  Histoplasmosis is a fungal infection of the lungs causing muscle aches, fever, chest pain, cough, and more.

• Anemia, iron deficiency

  Anemia , a lack of red blood cells, can cause fatigue, pale skin and gums, brittle nails, irritability, and more.

• Carbon monoxide poisoning

  Carbon monoxide poisoning can be fatal, symptoms include headache, dizziness, nausea, and vomiting.

• Chronic kidney disease

  Chronic kidney disease is a condition of the kidneys that can cause high blood pressure, fatigue, and weakness.

• Dehydration (Adult)

  Dehydration, or not getting enough fluid, causes low blood pressure, weakness, dizziness, fatigue, and nausea.

• Porphyria

  Porphyria is a condition that can affect the nerves and skin, making the skin extremely sensitive to sunlight.

• Radon exposure

  Breathing in high levels of radon over time can cause lung cancer. 

• Restless legs syndrome

  Restless leg syndrome causes intense discomfort in your legs and an overpowering urge to move them. 

• Sarcoidosis

  Sarcoidosis is a rare disease that can cause swelling and hard lumps in the lymph nodes and organs. 

• Supraventricular tachycardia

  Supraventricular tachycardia is fast heart rhythm starting in one of the upper chambers of the heart. 

• Vitamin B12 deficiency

  Vitamin B12 deficiency symptoms include fatigue, pale skin, weakness, sleepiness, numbness, weakness, and more.

• Malnutrition

  Malnutrition occurs when the body isn't getting enough nutrients; sometimes the condition is life-threatening.

• Hyperparathyroidism

  Hyperthyroidism causes weight loss, shakiness, tiredness, sensitivity to heat, insomnia, and more.

• Anemia, hemolytic

  Hemolytic anemia occurs when there aren't enough red blood cells in the blood. 

• Renal cell (kidney) cancer

  Renal cell cancer is a type of kidney cancer that can cause bloody urine and persistent pain in the side. 

• Radiation sickness

  Radiation sickness is caused by a high dose of radiation, and causes vomiting, diarrhea, hair loss, and more.

• Hypopituitarism

  Hypopituitarism is a rare disorder of the pituitary glands, which can cause many different symptoms.

• Pseudohypoparathyroidism

  Pseudohypoparathyroidism is a rare inherited condition that can lead to cramps, muscle spasms, and more.

• Small intestine cancer

  Small intestine cancer is rare and often has no symptoms, but can cause symptoms in its advanced stages.

• Lead poisoning

  Lead poisoning causes sudden pain on either side of the lower back, urinary issues, nausea, fever, and chills.

• Typhoid fever

  Typhoid fever is a life-threatening illness and causes fever, general aches and pains, headache, and weakness.

• Mesenteric lymphadenitis

  Mesenteric lymphadenitis is an inflammation of abdominal lymph nodes causing pain, diarrhea, fever, and more.

• Bird (avian) flu

  Bird flu is spread to people from birds and causes fever, cough, sore throat and muscle aches.

• Throat cancer

  Throat cancer can cause symptoms including difficulty swallowing, hoarseness, and chronic cough.

• Cat-scratch disease

  Cat scratch disease is a bacterial infection caused by a cat scratch or bite.

[upu2]

Sounds very much like dehydration

[Toscano]

Most likely you are dehydrated , lacking electrolytes , that you are not drinking enough water .  Water from mountain streams ABOVE human habitation and agricultural level maybe OK .  If you are exploring in the wild you can buy small water filtration outfits to purify water from dubious sources .

[Stokakrishna]

I go for UTI (urinary tract infection).

 Or kindney stones. 

[UnkleGoooose]

This brown "wee", did it come out of the back or the front of you, or possibly you were too drunk to tell.

[moonseeker]

What do we have Dr. 's and hospitals for folks? We got TV that resolves just about any issues we might have.... Have a great day. MS>

[JRinPDX]

Kidney stones?

[moontang]

basic urine exam is under 100 THB at many walk in commercial labs...pretty easy to see if you  are in the normal ranges.  Most folks don't drink enough water.  Good luck!

[JPFIT]

Check the chart but to be honest if you are trying to be healthy you are playing Russian roulette with your sex life! I know it’s like jumping in a puddle without wellegton boots on but better to be safe than sorry. Good luck hope it’s just dehydration 

[NanLaew]

4 hours ago, Catoni said:

Restless legs syndrome

Restless leg syndrome causes intense discomfort in your legs and an overpowering urge to move them. 

The OP needs to stop running about and all the other symptoms will probably disappear.

[moontang]

1 minute ago, JPFIT said:

Check the chart but to be honest if you are trying to be healthy you are playing Russian roulette with your sex life! I know it’s like jumping in a puddle without wellegton boots on but better to be safe than sorry. Good luck hope it’s just dehydration 

Thanks, JP, I am going to send that one to my Dad, who doesn't drink enough water.

[Hardie]

With hepatitis, my urine was like Coca-Cola, energy levels non-existent, and "all looks yellow to the jaundiced eye" per the quote. I can't imagine that prostate would have anything to do with it, swollen or cancer, though kidney stones might. I get those, and have had them lodge in my bladder, suspect one disintegrated last week and caused me dark urine one day, then passed. They can sometimes cause extreme fatigue and pain when passing, too, so just an idea. If you're American, don't assume that they'll get it right there. I've had better luck in Thailand. Bumrungrad is high-priced, but maybe the best option. I've had good results at Sukhumvit at half the price. Good luck...

[Monkeyrobot]

Maybe you going colour blind ? Only joking, hope you find the problem. 

[geoff65]

Get your kidneys checked and see what your EGFR (kidney function)is this will give you an idea if you have early kidney damage, chronic kidney disease (CKD). I have been through this and the signs were there for a long time, cut long story short I end up  with kidney failure was on dialysis for 2 years and recently had a kidney transplant in April this year.get them checked properly coz you don’t won’t to go through what I did, I’m still recovering.