Jonathan Ritter, PharmD, phd (Pharmacology) | created by Puya Yazdi, MD | last updated: April 7, 2021

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Urobilinogen is a byproduct the bilirubin that is eventually got rid of through the stool and urine. Although urobilinogen is normally discovered in the urine, higher or lower levels might be a authorize of a liver problem. Check out on to discover out what urobilinogen is, exactly how it have the right to be tested, and what that levels may reveal around your health.

What is Urobilinogen?

Urobilinogen is a colorless pigment created from the failure of bilirubin by gut bacteria. The majority of this link is excreted in feces, and also a tiny amount is reabsorbed and also excreted in the urine <1>.

When bilirubin manufacturing increases since of red blood cell devastation (hemolysis) or liver disease, urobilinogen levels rise in the urine. On the other hand, when inadequate bilirubin reaches the gut early out to reduced bile flow, urobilinogen manufacturing is reduced, resulting in extremely low or missing urinary urobilinogen levels. For these reasons, a urobilinogen test is provided with other tests to aid detect liver, gallbladder, or red blood cell difficulties <1, 2>.

Urobilinogen Tests

Urobilinogen is most frequently measured in the urine. This is typically done as component of a urinalysis test, i beg your pardon measures numerous other building materials in her urine, including proteins, ketones, and also glucose. A urinalysis is often part of a routine wellness exam to display for beforehand signs of an illness <3>.

Your doctor may additionally order this test to screen existing liver conditions, or if you have symptoms the liver disease. These incorporate <4, 5, 6>:

yellowing the the skin and also eyes (jaundice)dark-colored urinenausea and also vomitingitchy skinchillsfeverloss the appetiteweakness/fatiguedisorientation or confusion

Urobilinogen level can likewise be measure in the stool (although this is no done together often).

Normal Levels

Urobilinogen is normally found in trace amounts in the pee (0.2 – 1.0 mg/dL) <7>.

Urobilinogen levels 1.0 mg/dL are thought about high <8>.

However, these values vary indigenous lab come lab.

Limitations

One study found that back the pee urobilinogen test to be a good screen for elevated blood bilirubin levels, the was not as advantageous for detecting liver problems due to a high proportion of false-negative outcomes <9>.

The urobilinogen test, by itself, is not sufficient to diagnose any type of condition. Talk to her doctor about what your test outcomes mean and how to manage any kind of underlying health problems <10>.

Low Urobilinogen Levels

Symptoms

Symptoms of short urobilinogen levels rely on the underlying cause. If friend have reduced bile flow, you may experience <11, 12>:

Itchy skinFatigueYellow complexion (jaundice)Dark urineLightly colored or foul-smelling stoolAnorexiaNauseaVomitingWeight loss

Causes

1) lessened Bile Flow

Cholestasis, or decreased bile flow from the liver to the intestines, can reason bilirubin to build up in the bloodstream rather of being removed normally. This can reduce the production of urobilinogen, which leads to lower levels in the pee <1, 13>.

Urinary urobilinogen level were considerably lower in babies with biliary atresia (narrow, blocked, or lacking bile ducts) contrasted to healthy infants in one observational study of 75 babies <13>.

Causes of cholestasis encompass <12>:

Bile duct blockage (gallstones, cysts, and tumors)Liver disease/damagePregnancySevere infectionPancreatic cancer

Generally, if you have symptoms the liver disease and bilirubin in your urine but an absence of or low urobilinogen, this suggests that not sufficient bile is flowing to your gut <1, 5>.

2) details Medications

Broad-spectrum antibiotics destroy gut bacteria, which have the right to prevent the manufacturing of urobilinogen <1>.

In a study of 18 healthy and balanced people, antibiotic therapy for 6 days diminished urobilinogen levels in the stool <14>.

False an adverse Results

Some factors can interfere with your lab tests and also cause false an adverse results. These encompass <1, 3, 15, 8>:

Ways to boost Urobilinogen

1) Treat underlying Conditions

Address any type of underlying conditions that are resulting in low urobilinogen levels.

If you have cholestasis (reduced bile flow), promote the health of your liver by:


2) evaluation Your Medications

If you space taking antibiotics, talk about lowering her dose or alternative options v your doctor.

High Urobilinogen Levels

Symptoms

Symptoms of high urobilinogen level in your urine rely on the basic cause. If you have actually a liver or gallbladder disease, you might experience <4, 5, 6>:

yellowing of the skin and also eyes (jaundice)dark-colored urinenausea and vomitingchillsfeverloss the appetiteweakness/fatiguedisorientation or confusion

If you have hemolysis (red blood destruction), friend may have <25>:

dark urineback painyellow skin (jaundice)rapid heart price (tachycardia)anemia

Causes

1) Liver an illness or Damage

Liver damage and disease (e.g., viral hepatitis and also liver cirrhosis) can increase bilirubin levels, result in higher urobilinogen levels in the to pee <1>.

Urobilinogen levels likewise correlate with blood level of liver enzymes (e.g. ALT, AST), which climb in solution to liver damages <26>.

2) too much Red Blood cell Breakdown

Conditions that boost the destruction of red blood cells (e.g. Hemolytic anemia, pernicious anemia, intravascular hemolysis, congestive heart failure) raise bilirubin levels, which rises the manufacturing of urobilinogen in the gut <1, 27, 3>.

Usually, if you have actually excess red blood cell destruction (hemolysis), girlfriend will have actually urobilinogen in her urine however undetectable quantities of bilirubin <1, 28>.

3) Malaria

Urobilinogen level were higher in 365 malaria patients <29>.

Another research of 620 human being with malaria uncovered that the visibility of urobilinogen in the urine was connected with an increased risk of significant malaria through the adhering to complications <30>:

Thrombocytopenia (low platelet count)Neurological dysfunctionLiver dysfunction

False optimistic Results

Factors that have the right to lead to false-positive results incorporate <8>:

Elevated nitrate level in the urineHigh carbohydrate intakeTiming (test is done later in the afternoon)Drugs that make the urine red, such together phenazopyridine (Pyridium)

Ways come Decrease Urobilinogen

1) Treat underlying Conditions

Address any kind of underlying conditions that are causing low urobilinogen levels. Speak to your doctor around why friend may have actually low urobilinogen and also what ideal therapies space available.

2) Limit her Alcohol Intake

Drinking too lot alcohol can damage liver cells and also worsen currently liver problems <23>.

Alcohol also decreases red blood cells, which might exacerbate anemia. One observational research of 17.7k people found the red blood cell count was diminished by alcohol consumption, with even the lowest intake showing a far-ranging decrease in red blood cell <31>.

3) review Your Medications

Some drugs or supplements can damages the liver <5, 24>:

Paracetamol (Tylenol)AspirinNon-steroidal anti-inflammatory drugsMethyldopaAmiodaroneMonoamine oxidase inhibitorsPhenothiazines (such together chlorpromazine)Sodium valproateOral contraceptives and hormone replacement therapyChaparral leafEphedraGermanderKavaSennaVitamin A

Have a medical professional or pharmacist evaluation your drugs to watch if any could it is in harmful to the liver.

4) improve Sleep Quality

Good sleep is crucial for liver health. Short sleep duration and poor sleep quality significantly increased the incidence the non-alcoholic fat liver an illness (NAFLD) in an observational examine of 69k civilization <19>.

5) Drink much more Coffee

Drinking moderate come high amounts of coffee (regardless of caffeine content) on a continuous basis may advantage liver health. In one observational study of 28k people, drinking more than 3 cups of coffee per day was associated with reduced levels that liver enzymes (e.g. ALT, AST, ALP, and GGT) <17>.

6) Exercise

If you have anemia result from red blood destruction exercise may help. Center physical activity signals the human body to produce much more red blood cells to boost the oxygen supply to your muscles <33>.

However, avoid much more intense and also strenuous forms of exercise, together these can damage and also destroy red blood cells. This is just one of the factors endurance athletes often have anemia <34>.


Dr. Puya Yazdi is a physician-scientist with 14+ years of experience in clinical medicine, life sciences, biotechnology, and nutraceuticals.

See more: Which Substance Is An Arrhenius Acid, Arrhenius Acid Definition And Examples


As a physician-scientist with field of expertise in genomics, biotechnology, and nutraceuticals, he has made it his mission to bring precision medication to the bedside and aid transform medical care in the 21st century. He received his undergraduate education at the university of California at Irvine, a medical Doctorate indigenous the university of southerly California, and was a Resident doctor at Stanford University. He then proceeded to offer as a Clinical other of The California institute of Regenerative medicine at The college of California at Irvine, wherein he carried out research the stem cells, epigenetics, and also genomics. He was likewise a clinical Director for Cyvex Nutrition prior to serving together president the Systomic Health, a biotechnology consulting agency, wherein he offered as an skilled on genomics and other high-throughput technologies. His ahead clients encompass Allergan, Caladrius Biosciences, and also Omega Protein. He has a background of peer-reviewed publications, intellectual property discoveries (patents, etc.), clinical attempt design, and also a thorough expertise of the regulation landscape in biotechnology. That is leading our entire scientific and medical team in order come ensure accuracy and scientific validity of ours content and products.