Urobilinogen is a substance in your urine that can tell you a lot about how healthy your liver is. A normal range for urobilinogen in your urine is 0.1 to 1.8 mg/dL. High levels of urobilinogen are a sign that your liver or bile ducts need to be checked out.
In this post, I’m going to explain what urobilinogen is, what the normal range is, and what it means if your urobilinogen is high.
What is Urobilinogen?
Urine tests are a good way to monitor your liver and metabolism. Urobilinogen is produced when bilirubin is broken down by gut bacteria.
That’s good because it means your liver is handling bilirubin well and your gut bacteria is active.
Bilirubin is a yellow pigment produced when your body breaks down old red blood cells. Urobilinogen is a colorless breakdown product of bilirubin.
It’s a sign of a healthy metabolism. When we see high levels of urobilinogen in urine it can be a sign of underlying liver, bile duct or red blood cell problems.
High urobilinogen can be a sign of liver cirrhosis or hepatitis.
Urobilinogen that’s reabsorbed into the bloodstream and excreted into urine is a liver function marker.
High levels of urobilinogen in urine can be a sign of liver problems like hepatitis or cirrhosis. Low levels can be a sign of bile duct or gallbladder problems.
Normal Urobilinogen Levels in Urine
You should know what’s normal for urobilinogen in urine. Urobilinogen should be less than 1 mg/dL.
A more accurate range is 0.1 to 1.8 mg/dL. Anything above this range is abnormal and needs to be investigated.
In a normal person urobilinogen in urine is good. It’s produced when bilirubin is broken down by gut bacteria.
That’s good because it means your liver is handling bilirubin well and your gut bacteria is active.
Causes of Abnormal Urobilinogen Levels
High or low urobilinogen levels can be a sign of underlying health problems. High levels above 2.0 mg/dL are abnormal and can be caused by a range of conditions.
Here are some possible causes of high urobilinogen levels:
High Urobilinogen Levels
High urobilinogen levels are a sign of liver dysfunction and can be caused by a range of conditions. Here are some possible causes of high urobilinogen levels:
- Liver disease
- Certain medications
- Gastrointestinal problems
- Nauseia and vomiting
- Weakness
- Abdominal swelling
High urobilinogen levels can also be a sign of hemolytic anemia, which is a condition where your red blood cells are breaking down prematurely.
This can be caused by a variety of factors, including enzyme deficiencies or autoimmune disorders.
Low Urobilinogen Levels
Low urobilinogen levels are rare and can be a sign of serious liver problems. Here are some possible causes of low urobilinogen levels:
- Biliary obstruction
- Problems with the bile ducts (gallstones, infection)
- Certain medications
- Changes in gut flora
- Variations in how bilirubin is metabolized by gut bacteria
If your urobilinogen levels are low, you may not have any symptoms at first. As liver damage progresses, you could develop dark yellow or brown urine and pale stools.
This is a sign of cholestasis and means you’re not producing enough bile to digest fat.
You could have gallstones or an infected bile duct.
Low urobilinogen levels can be a sign of serious liver damage, so it’s important to treat the underlying cause.
Symptoms of Abnormal Urobilinogen Levels
Some people with high or low urobilinogen have no symptoms. Others will have symptoms as their liver function declines.
Here are some possible symptoms of high and low urobilinogen:
Symptoms of High Urobilinogen
- Yellowing of skin and eyes (jaundice) from liver disease
- Dark yellow or brown urine
- Fatigue
People with high urobilinogen are very tired. They are so tired they can’t even do daily tasks.
If you have high urobilinogen you may also have symptoms of hemolytic anemia such as:
- Jaundice
- Fatigue
- Pale yellow skin
Low Urobilinogen Symptoms
- Light colored stools
- Dark yellow or brown urine
Pale or clay colored stools is a sign of impaired bile flow and low urobilinogen.
People with low urobilinogen may not have symptoms in the early stages of liver damage. As liver function declines they may feel generally unwell.
Urobilinogen Urine Test
The urobilinogen urine test is a great way to monitor your liver health and track conditions that affect your liver. A urine test is performed by collecting a sterile urine sample.
Purpose of the Test
The urobilinogen urine test is performed to evaluate liver disease and damage. It measures the amount of urobilinogen in your urine.
Your healthcare provider will visually inspect your urine, check its chemical composition, and examine it under a microscope.
This test is often ordered when your healthcare provider suspects liver disease or hemolytic anemia. It’s also used to monitor people with ongoing liver disease.
In some cases, your doctor may also order blood tests to measure bilirubin and liver enzymes.
If your urobilinogen test is abnormal your healthcare provider may order further testing to find out why.
How Do I Prepare for the Test?
Preparation is important to ensure accurate results. Here’s how you can prepare for a urobilinogen test:
- Wash your hands thoroughly
- Use a cleansing wipe to clean your genital area
- Disclose any medications you’re taking, especially antibiotics
- Let your healthcare provider know if you have any bleeding disorders or take blood-thinning medications
It’s important to provide a sufficient urine specimen.
You’ll need to collect at least 30 milliliters of urine, but 60 milliliters is preferred.
Make sure to use the right collection methods to keep the specimen clean and uncontaminated.
Conducting the Test
A clean catch technique is used to perform the urobilinogen test. Midstream urine is collected to reduce the risk of contamination. Strict clean catch protocols are important to ensure accurate results.
Interpreting Urobilinogen Test Results
Understanding your urobilinogen test results is important to know what it means to your health and what treatment you may need.
I’ll explain how to interpret test results and what to do.
What Do High Levels Indicate?
High urobilinogen in urine may indicate liver dysfunction or increased hemolysis and could be due to liver damage from medications or diseases like hepatitis or cirrhosis.
If the liver can’t process urobilinogen well, its concentration increases in urine. Increase in bilirubin due to massive red blood cell destruction can also increase urobilinogen.
Hepatitis or cirrhosis can impede liver function significantly so it can’t handle bilirubin conversion properly.
This obstacle results to higher concentration of urobilinogen in urine and that’s why regular check up is important to detect early.
When urobilinogen is high, it’s time to investigate and need medical attention.
What Do Low Levels Indicate?
A low level of urobilinogen in your urine is a sign that your body isn’t getting enough bile.
This is more likely if you have major liver damage or gallstones. A low level of this substance is a sign of cholestasis, which is a backup of bile flow.
A zero level of urobilinogen is a sign of severe liver damage or blocked bile ducts.
You’ll need to see your doctor to treat any liver damage and to clear a blockage.
Treatment for Abnormal Urobilinogen Levels
The treatment for abnormal urobilinogen levels depends on the cause of the problem.
A person with liver disease, for example, will be managed differently than someone with a blocked bile duct.
Treating High Urobilinogen Levels
Seeing high urobilinogen levels in your urine could mean your liver needs attention. It might be due to issues like jaundice or cirrhosis.
The best way to handle this is by focusing on the liver problem causing it.
Treating conditions like hepatitis or managing cirrhosis can help. If hemolytic anemia is the cause, controlling the breakdown of red blood cells is important.
Regular urine tests can give you a good idea of your liver’s health.
Some medications might raise urobilinogen levels, so it’s wise to discuss any medicines with your doctor. The key is to find the cause and address it directly.
Treating Low Urobilinogen Levels
When your urobilinogen levels are low or not showing up in your urine, it might mean there’s a liver issue or a blockage in the bile ducts.
To get things back on track, it’s important to address these issues. This could involve dealing with liver concerns or clearing blockages.
Eating plenty of fruits and veggies can help keep your urobilinogen levels balanced.
Some medications might lower these levels, so it’s wise to chat with your doctor about any meds you’re taking.
To restore your liver and bile flow, focus on fixing the main causes of the abnormal urobilinogen levels.
What Affects Urobilinogen Test Accuracy?
There are several factors that can affect urobilinogen test accuracy. It’s good to understand what these factors are so you can get accurate results and diagnose any underlying health issues.
False positives
Several medications can affect urobilinogen test accuracy and cause false positive results. These medications are:
- Antibiotics (especially ampicillin and sulfa medications)
- Sulfonamides
- Vitamin C (large doses)
Other substances like porphobilinogen and sulfonamides can also cause high urobilinogen levels.
False positives are when the test shows high levels but your actual urobilinogen levels are normal.
This can cause unnecessary worry and additional testing. Know these interfering substances when your healthcare provider interprets your test result.
False negatives
Light and high temperatures can affect urobilinogen test accuracy and cause false negative results.
False negatives are when the test shows low levels but your actual urobilinogen levels are high.
Changes in temperature during storage can also affect urobilinogen test accuracy and cause falsely low results. Certain additives like formalin can interfere with measurable urobilinogen.
Take care in handling and storing your urine specimen to get an accurate urobilinogen evaluation. Improper handling and storage can make a big mistake in judging your true urobilinogen levels.
Wrap Up
Urobilinogen in urine shows how your liver is doing. It’s good to know what’s normal and what isn’t.
High or low levels can mean different things, so it’s important to find and treat the cause.
Accurate testing helps reduce stress and extra tests. Regular urine tests can help you monitor your liver health and catch issues early.
I suggest staying in touch with your doctor and making urinalysis a regular part of your health routine. This can help keep your liver healthy and catch any issues early.
