Pee Smells Like Onions

Pee Smells Like Onions
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Brunzel NA. Physical examination of urine. In: Fundamentals of Urine and Body Fluid Analysis. 4th ed. Elsevier; 2018.
McPherson RA, et al., eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St. Louis, Mo.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Aug. 10, 2016.
Shirasu M, et al. The scent of disease: Volatile organic compounds of the human body related to disease and disorder. The Journal of Biochemistry. 2011;150:257.
Chernecky CC, et al., eds. Urinalysis. In: Laboratory Tests and Diagnostic Procedures. 6th ed. St. Louis, Mo.: Saunders Elsevier; 2013. https://www.clinicalkey.com. Accessed Aug. 11, 2016.
Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 13, 2016.

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Symptoms
Urine odor
Basics
Causes

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Urine consists mainly of water. It's the amount and concentration of various waste products excreted by the kidneys that causes urine odor.
Urine that contains a lot of water and few waste products has little to no odor. If urine becomes highly concentrated — a high level of waste products with little water — your urine may have a strong ammonia odor.
Some foods and medications, such as asparagus or certain vitamins, can cause a noticeable urine odor, even in low concentrations. Sometimes, unusual urine odor indicates a medical condition or disease, such as:
Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.
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By
Jessica Migala
January 23, 2021

Urine smells are normally different from person to person, but a few specific smells can tip you off that something's going on with your health.

Image Credit:
Mihailgrey/iStock/GettyImages

1. If Your Urine Smells Like Ammonia...

3. If You Have Sweet-Smelling Urine...

5. If Your Urine Smells Really Bad...

6. If Your Pee Smells Like Sulfur...

7. If Your Urine Smells Like Coffee...

Sometimes it smells like nothing. Other times, like when you wake up in the morning, your pee has that, well, "strong pee smell." Or it might smell fruity, sour or even fishy. So, what's going on?
"Urine will have a characteristic odor that may be different in each person," Piyush Agarwal, MD , professor of surgery and urology and director of the Bladder Cancer Program at The University of Chicago Medicine, tells LIVESTRONG.com.
But when there's something funky going on — your urine does not smell "normal" to you — you probably have questions. Before you rely on your pee smell to self-diagnose, though, keep in mind that smells can be up for interpretation. What you'd describe as pee that smells sweet, another person might say smells fruity.
What's more, while odor is important, it's often not as telling as other signs, including urine color.
So pay attention to the stink and report any concerns to your doctor, but don't assume the worst if the aroma you're producing is a little off.
Now, let's get on with it. If your urine smells like the following, here's what may be going on:
Urine is mostly made up of water, with the addition of waste products like urea. If you have foul-smelling or pungent urine that has a strong ammonia scent, then it's likely you're dehydrated , leading to more concentrated urine.
Where doctors worry is when you have additional symptoms. For instance, an ammonia smell to your urine along with burning, pain with urination and fever may point to a urinary tract infection (UTI), Dr. Agarwal says.
Fix it: Drinking more water will dilute your urine, which will tame the smell. You'll know you're properly hydrated if your pee is somewhere between clear and a light yellow color, per the Cleveland Clinic .
If you have additional symptoms, make an appointment with your doctor.
Trichomoniasis is a sexually transmitted disease (STD) that can affect people of any sex. People assigned male at birth often have no symptoms, but those assigned female can have a fishy-smelling vaginal discharge. While discharge is distinctly different than urine, that may be the scent you're smelling when in the bathroom.
Along with the odor, discharge may be greenish-yellow, and you may experience vaginal irritation, notes the Centers for Disease Control and Prevention .
Fix it: This infection is cured with a single dose of antibiotics.
It might be an infection, or it could be diabetes.
Some patients who have UTIs actually describe the smell of their urine as sweet, Dr. Agarwal says.
More commonly, this might be a sign of diabetes. If you have uncontrolled diabetes, sugar is being eliminated in your urine, which can add a sweet smell.
"This would be accompanied by going to the bathroom more frequently and an increased urge to go," Dr. Agarwal says.
It could be dehydration, or maybe it's the supplement you're taking.
As we noted before, your pee is more concentrated when you're dehydrated, so it has that strong pee smell.
Another cause behind that smell, though, can be B-6 vitamins, according to the Cleveland Clinic . The vitamin is water-soluble, meaning it is eliminated in the urine. Check your supplements and multivitamin: How much B6 do they contain?
Fix it: Drink more water if you're dehydrated. If it's your supplement, consider switching to a vitamin with lower levels of B-6.
Sometimes the GI tract can form an abnormal connection to the urinary tract, called a fistula. "That causes some stool contents to be eliminated in the urine," Dr. Agarwal says.
Your urine may take on a really nasty smell because of these fecal particles, may have a brownish color and you may hear air passing through your urethra as you're peeing. However, foul-smelling urine might be the first sign, he says.
Fix it: This warrants a call to your doctor, who will look for the underlying cause of the fistula (such as colon cancer or an inflammatory disorder) and recommend surgery, according to the Urology Care Foundation .
Did you just eat asparagus, perhaps?
"Foods will change the smell of urine," Dr. Agarwal says. Asparagus is by far the most famous for doing this, and that's because sulfur byproducts of the veggie are being eliminated in the urine.
Fun fact: Lots of people can't smell "asparagus pee" because of certain genetic variants that make them unable to detect this odor. In one study published in The BMJ in 2016, about 60 percent of people claimed they didn't have smelly pee after eating asparagus. (They really did, but their noses were none the wiser.)
Other foods that are known to change your urine odor include garlic, salmon, Brussels sprouts and curries, Dr. Agarwal says.
Fix it: Not much you can do here, really — the smell will go away on its own.
We'll keep this short and sweet: "Some people notice that they have a coffee smell to their urine after drinking coffee," Dr. Agarwal says.
Fix it: This is harmless — keep on caffeinating.
If you're confident that the smell is not related to something you ate or a change in diet, call your doctor, who may want to evaluate you for an underlying cause, like a UTI or STD.
If you have additional symptoms, like burning, increased peeing frequency or a cloudy appearance to your urine, you should also be evaluated.

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