What Is Occult Blood in Urine?

Rebekah Kuschmider
Rebekah Kuschmider
June 29, 2023
min read
Technically reviewed by: 
Diagnox Staff
What Is Occult Blood in Urine?

Urine tests can reveal a lot about your health. At-home tests, such as Urinox-10, check for the presence of substances in your urine, including protein, glucose, bilirubin, ketones, and blood. Identifying and tracking these substances can help you monitor conditions that affect kidney, liver, and endocrine functions, and alert you to urinary tract infections.

What Is Occult Blood in Urine?

The presence of blood in the urine, called hematuria, is often a signal of inflammation or an infection. In some cases, the volume of red blood cells present in the urine makes it appear red or pink. This is called gross hematuria.

In other cases, the red blood cells are only visible with a microscope. This hidden blood is known as occult hematuria — or sometimes as microscopic hematuria.

Detecting Occult Blood in Urine Tests

Dipstick urine tests, such as at-home testing kits or the kind used in doctors’ offices, can detect occult blood in the urine. However, test strips cannot show the precise quantity of blood. They provide qualitative (presences/absence) or semi-quantitative (rough estimate of the quantity) results. A positive dipstick test primarily indicates that you need further testing to gather more information.

Dipstick urine tests detect occult blood semi-quantitatively (approximate indication of quantity). Lab testing can determine the precise amount of red blood cells, guiding further investigation for significant microscopic hematuria.

Your doctor can order lab testing such as an occult blood urinalysis to examine a urine sample under a microscope. This will reveal how many red blood cells are in your urine so your healthcare team can determine whether the amount is significant or not [1]:

  • Significant microscopic hematuria: 3 or more red blood cells (RBC)/hpf (≥ 3 RBC/hpf)
  • Insignificant microscopic hematuria: 2 or fewer RBC/hpf (0-2 RBC/hpf)

If the microscopic hematuria is considered significant, your doctor may suggest further testing for underlying health issues that could be the cause of occult blood in the urine.

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Causes of Occult Blood in Urine

There are a number of health conditions that can cause occult blood in urine. Some of the most common causes include [2]:

Blood in the urine can also indicate more serious illnesses, such as:

  • Kidney cancer
  • Bladder cancer
  • Prostate cancer
  • Kidney disease
  • Chronic illnesses such as sickle cell disease
Runner's bladder, or marathoner's hematuria, is a medical condition in athletes who undergo intense workouts, leading to episodes of blood in urine. It often resolves without medical intervention.

It is possible to have blood in the urine due to non-harmful conditions as well. Athletes can develop blood in urine after extended exercise, and menstruation and endometriosis can also be contributors [3].

Certain foods like rhubarb or beetroot can discolor urine and make your urine appear as if it has visible blood in it. If you are concerned about hematuria, avoid these foods to ensure your urine's appearance reflects your health and not your diet.  

When To Call a Doctor

If you use an at-home urine test such as Urinox-10 and receive a positive result for occult blood in the urine, you should call your doctor. You may need additional testing to determine how much occult blood is in your urine and diagnose the cause.


1] A. Marcin, “What DoesOccult Blood In Urine Mean and How Is It Treated?” Healthline.com, April 3,2023. Available Online here, [Accessed: June 6, 2023].

[2] Mayo Clinic Staff, “Blood in urine (hematuria),” MayoClinic.com, No Date. Available Online here, [Accessed June 6, 2023].

[3] “Hematuria,” ClevelandClinic.com,August 16, 2022. Available Online here, [Accessed: June 6, 2023].

About the Author
Rebekah Kuschmider

Rebekah has been writing about culture, health, and politics since 2010. She has a masters degree in Arts Policy and Administration from The Ohio State University. Her work has been seen at WebMD, The Candidly, MedicineNet, YourTango, Ravishly, Babble, Scary Mommy, Salon, Role Reboot, The Good Men Project, SheSaid, Huffington Post, and Mamamia. She is a former cohost of the weekly podcast The More Perfect Union. Rebekah lives in Maryland with her husband, two kids, and a dog who sheds a lot.

About the Reviewer
This blog was
Technically reviewed by: 
Diagnox Staff

Diagnox Staff consists of a multidisciplinary team of scientists, content writers, and healthcare professionals with an expertise to create and review high-quality, informative, accurate, and easy-to-understand content for both professionals and everyday readers. Our staff follows strict guidelines to ensure the credibility and authenticity of the information, reviewing them independently and verifying them by various scientific and technical sources to ensure accuracy. Our review team believes in delivering knowledge free from bias to improve public health and well-being.

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