What is Urobilinogen in Urine?

Elizebeth O’Neill
Elizebeth O’Neill
November 25, 2022
8
min read
What is Urobilinogen in Urine?

What is urobilinogen in urine?

Urobilinogen is a byproduct of bilirubin produced in your body when old red blood cells break down. Your liver then processes the bilirubin to make bile, a fluid that helps digestion. As bile flows into the intestine, the bilirubin it carries is converted by good bacteria into several compounds collectively called urobilinogen. Most of the urobilinogen is flushed out of the body with stool, but around 10% to 15% of it enters circulation. It is then recycled back to the intestines. A small quantity of urobilinogen entering your bloodstream is excreted into your urine.

How is Urobilinogen in urine related to your health?

It is normal to have a small amount of urobilinogen in urine. A higher-than-normal amount is a potential sign of a liver condition like hepatitis, cirrhosis , or hemolytic anemia. Less than normal level is also a sign of a potential problem with your liver, gallbladder, or bile ducts (that transport bile/bilirubin from the liver to the intestines).

Abnormal levels of urobilinogen in urine are related to liver diseases.

Why testing urobilinogen in urine is essential for your liver health?

It is a standard clinical practice to test urine for urobilinogen (and bilirubin) to diagnose liver problems. The test may also be required if you experience symptoms of liver disease or hemolytic anemia . It is good for you to know the most common symptoms of liver disease, such as:

  • Yellowing of skin and eyes (Jaundice)
  • Appetite loss
  • Fatigue and weakness
  • Nausea and vomiting
  • Abdominal swelling and pain
  • Swelling in ankles and legs
  • Dark urine and light-colored stool
  • Skin irritation

Hemolytic anemia manifests itself through symptoms such as:

  • Jaundice
  • Fatigue and exhaustion
  • Headache, confusion, and dizziness
  • Palpitations (feeling of faster, harder heartbeat)  

What do high or low urine urobilinogen levels indicate?

Urine urobilinogen levels above or below the normal range signify different conditions.

Liver conditions related to high urobilinogen in urine:

Hemolytic Jaundice/Anemia:

  • Excessive breakdown of red blood cells results in higher bilirubin production, which the liver has to process. As a result, more bilirubin is drained into the intestines. This also leads to a higher concentration of urobilinogen entering your bloodstream, which is then excreted into the urine.  

Cirrhosis:

  • Due to liver damage, liver cells fail to remove the circulating urobilinogen. As a result, excessive amounts of urobilinogen appear in the urine.

Liver condition related to low urobilinogen in urine:

Obstructive Jaundice:

  • Due to an obstruction of the bile duct, bilirubin fails to enter the intestines. As a result, a sufficient quantity of urobilinogen is not formed, which is reflected in low urobilinogen levels in the urine.

What options do I have to test urobilinogen in urine?

Urinalysis (chemical testing of urine) is a standard non-invasive procedure to test urine urobilinogen levels. Urinalysis can be performed at a professional lab or home. The testing at the lab can be conducted using a microscopic examination of the urine or with a professional urine dipstick. Testing at home is usually performed using an over-the-counter OTC urine test strip. (Dipstick, UA strip, urine test strip, or a reagent strip all mean the same.)

How is an at-home urine test performed?

You can conveniently perform an at-home urobilinogen in urine test using urine test strips in less than two minutes. The dipstick has a reagent that changes color when dipped in the urine sample. The color of the pad is compared with a color chart for interpretation. You should choose a clinical-grade dipstick test  that guarantees accuracy.

At-home urine urobilinogen test using a dipstick is easy and simple to perform and yields result within a minute.

How do I understand the urine urobilinogen results?

It is easy to interpret the results of the urobilinogen dipstick test. A light peach color on the dipstick test pad means your urobilinogen levels are within normal range. A positive urobilinogen test will result in the test pad changing its color from peach to bright pink. Darker shades of pink correspond to higher concentrations of urobilinogen which should be seen as a sign of liver disorder. A urine dipstick test can check normal and higher-than-normal levels of urobilinogen levels but is not sensitive enough to check abnormally low levels.

A light peach color of the urobilinogen reagent pad on the urine test strip indicates normal urobilinogen level in the urine.

When the urobilinogen in urine is higher than normal levels, the reagent pad changes color to pink.

What are the normal, high, and low ranges of urobilinogen in urine?

  • Urobilinogen normal range is up to 1.0 mg/dL (16µmol/L): It indicates a healthy liver function.
  • Low urobilinogen in urine is less than 1.0 mg/dL (3.2µmol/L): It typically indicates a bile duct obstruction.
  • High urobilinogen in urine is above 2 mg/dL (16µmol/L): It suggests liver diseases such as hepatitis or cirrhosis.

What should I do if my UA urobilinogen results are not normal?

You should immediately consult your doctor if your at-home urobilinogen test is not in the normal range.

Urobilinogen (and bilirubin) in urine tests are an excellent diagnostic tool to assess liver function. However, the test alone may not suffice to give a clear picture of the exact nature or specific condition of the liver problem. If necessary, your doctor may order a liver panel, which consists of a range of blood tests that assess the overall health of your liver.

If you are at risk of liver disease or facing liver problems, proactively monitor urobilinogen in your urine, as it can help you keep informed of your liver function and stay on top of your health. Urobilinogen in urine during pregnancy could be a cause of concern. You should consult your healthcare provider immediately if you observe abnormal urobilinogen levels in your urine.

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References
  1. John Hopkins Medicine, “Hemolytic Anemia,” Accessed Nov 25, 2022.
  2. Mundt, A. Lillian, Shanahan, Kristy. Graff's Textbook of Urinalysis and Body Fluids, Third Edition, China, 2016, 100-101.
  3. NHS, “Overview Cirrhosis,” National Honor Society, UK, Accessed Nov. 25, 2022.
  4. NIH Staff, “Urobilinogen in Urine,” National Library of Medicine, NIH.
About the Author
Elizebeth O’Neill

Elizabeth O’Neill is a highly experienced nursing professional with a passion for educating others about important health issues. With a degree in nursing and extensive experience in the medical field, she has dedicated her career to helping others live their best, healthiest lives.

In her current role as a medical content writer for Diagnox, Elizabeth is able to utilize her knowledge and experience to inform and educate consumers on the importance of proactive screening and overall health. She is particularly passionate about women's health issues, and loves working with Diagnox to spread awareness about these important topics.

Throughout her career, Elizabeth has consistently demonstrated her dedication to helping others and improving the health of her community. She is highly respected by her colleagues and is known for her professionalism, compassion, and expertise. Whether she is working directly with patients or writing articles to educate the public, Elizabeth is always focused on making a positive impact on the lives of others.

About the Reviewer
This blog was
Technically reviewed by: 
H. Ali, Ph.D.

Hussnain Ali received his Ph.D. degree in EE in 2015 from the University of Texas at Dallas, USA. He is the co-founder and the Chief Executive Officer (CEO) at Diagnox Health, Plano, TX 75024, USA, and a visiting research scientist at the University of Texas at Dallas. His academic and industry experience spans over 15 years in organizations like the Center for Advanced Research in Engineering, The University of Texas at Dallas, and Harman/Samsung. He has served as a co-PI on an RO1 grant from the National Institutes of Health (NIH). His research interests include biomedical devices, auditory rehabilitation, and cochlear implants. He has authored and co-authored over 70 international publications and has been awarded multiple US patents. His latest work at Diagnox encompasses the development of innovative healthcare and wellness products/solutions that provide convenient and affordable at-home screening/diagnosis. He aims to bridge conventional clinical diagnostic products with Artificial Intelligence (AI) and contemporary data-centric technologies to modernize the healthcare and wellness industry.

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