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Wellness Center

What is making my pee smell like ammonia?

01/07/2010

Question:

I am a 35 y/o mother of two pre-teen girls. In the last 18-24 mo`s or so (and completely out of the blue) I have noticed that my urine has an extremely strong odor. It doesn`t matter if it`s the first pee of the day, middle of the day or before bed... it reeks of ammonia. It also varies in color from "normal" to slightly dark or practically transparent. I`d say at least 75% of the time I urinate it smells so bad in the bathroom that I spray something to hide the odor. I can even smell it on my hands after wiping and washing. Yes, I said AFTER wiping AND washing! If nothing else, it`s a great reminder to wash my hands after using the toilet. I don`t eat a lot of asparagus or take vitamins on a regular basis. I don`t drink a lot of fluids, never have, but I am not dehydrated. I have been, however, staying in a foreign country (CAN) for sometime and am unable to see a doctor for financial reasons. I was diagnosed with HPV about 4-5 yrs ago and really can`t link the two. No signifigant weight gain/loss. No abdominal pain, etc... Regardless of what I eat or drink, I have this problem. My husband is concerned and I hide how concerned I am. I have a medical background and know this is not normal. Is there something I can do to narrow it`s origin (i.e. increase fluids, cut out bread, induldge in three Hershey Kisses daily, etc) since I am unable to see a doctor and probably won`t for at least si months? HELP! My kids and husband think I am dying... almost 2 yrs of this is about all I can handle, and so can they!

Answer:

Well, the good news is that you have had this for 2 years and haven't felt ill from it. 

A strong odor in the urine has a variety of causes. An ammonia odor is often associated with a urinary tract infection (bacterial break down of urea), concentrated urine from not drinking enough fluids, or liver problems. A Hershey Kiss a day would never hurt, but I doubt it will help pinpoint the problem. 

I would recommend starting out by making sure you are drinking at least 48 ounces of water a day (six 8-oz cups); this will help dilute your urine. You could also add some cranberry juice to your fluid intake (a glass a day) to kill any bacteria that may be in your urine. You can always go to a pharmacy or see a friend who has diabetes and check your blood sugar (finger stick) - fasting blood sugar should be below 110 mg/dl. 

If all that doesn't help, then you really do need to see a doctor to have a urine test and perhaps some blood tests done (checking your liver function).

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Response by:

W. Fred Miser, MD W. Fred Miser, MD
Associate Professor of Family Medicine
Director of Ohio State Medicine Residency Program
College of Medicine
The Ohio State University