Dark urine has many causes, and even what “dark urine” actually means is open to interpretation.

With HIV infections on the rise, the worry over dark pee as a possible symptom is also gaining momentum.

What Does Dark Urine Look Like?

Some people consider urine to be “dark” if it’s a dark yellow. Others consider a tea color to be on the lighter end of “dark.”

Sometimes the image of a cola color comes to mind when one thinks of “dark pee.”

“Dark urine can be scary,” says Walter Gaman, MD, FABFM, board certified in family medicine and the author of several award-winning books including “Age to Perfection: How to Thrive to 100, Happy, Healthy, and Wise.”

“There are a number of things that can cause dark urine, but the most common cause is a lack of fluids, or dehydration,” says Dr. Gaman.

“If the urine is brown or red, it may be a more serious problem with the kidneys, bladder or even the liver.”

HIV Positive, Dark Urine?

“While some people may be concerned that dark urine being a sign of HIV, it should not be considered a symptom of HIV,” says Dr. Gaman.

“Patients with HIV who have dark urine have this problem because of the additional health issues or involvement of the kidneys or liver in the disease process of AIDS, an infected state of the HIV virus.

“Hepatotoxicity, a toxic state of the liver, can be due to HIV medications and can also cause dark urine.

“Dark urine should be a cause for concern in anyone. If you are experiencing dark urine that is not corrected with drinking more fluids, or that is accompanied by pain or fever, seek medical attention immediately.”

Cola or tea colored pee can also be caused by excessively strenuous exercise, and in the CrossFit community, it’s a known sign of what they call Uncle Rhabdo – the nickname for the very serious condition of rhabdomyolysis.

This condition, which is no joking matter and causes tea colored urine, can lead to acute kidney failure and subsequent death.

It has causes other than excessively intense exercise, but when exercise is the cause, it’s called exertional rhabdomyolysis.

So whether you just completed a CrossFit workout of the day, or have been abstaining from sex for years and have no reason to believe you could ever be infected with HIV … dark urine of a cola, tea color or pink/red nature means an evaluation by a doctor as soon as possible.

Dr. Gaman is with Executive Medicine of Texas and is with the Staying Young Radio Show 2.0 podcast.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
Top image: James Heilman, MD
nypost.com/2017/04/07/deadly-condition-linked-to-crossfit-on-the-rise/ hiv infection, aids