Keto And Cloudy Urine: What's The Connection?

The keto diet is a low-carbohydrate method of eating that promotes the production of ketones, which are byproducts of fat metabolism. While the keto diet offers several benefits, it can also cause changes in urine colour, consistency, and odour. Many individuals on a ketogenic diet experience cloudy urine, which can be caused by several factors, including dehydration, ketone production, and vitamin and mineral imbalances. In this article, we will explore the causes, symptoms, and remedies for cloudy urine while on a keto diet and provide insights into the underlying physiological changes.

Dehydration

To prevent dehydration, it is important to prioritise hydration by drinking enough water and consuming hydrating foods. Aim for around 8 glasses of water per day, and incorporate more hydrating foods into your diet, such as cucumbers, watermelon, and leafy greens. These foods will help increase your water intake and promote urine clarity.

The keto diet can also cause digestive problems such as constipation or diarrhoea, which can lead to dehydration. If you are experiencing these issues, it is important to take steps to prevent dehydration by increasing your fluid intake and consuming electrolytes.

Furthermore, the keto diet restricts certain hydrating foods, which can make it challenging to stay properly hydrated. It is important to be mindful of this and take proactive steps to ensure adequate hydration.

If you feel extremely dehydrated, even after taking the necessary precautions, do not hesitate to consult your doctor. Severe dehydration can lead to serious health issues, including seizures and coma.

Ketone production

The keto diet promotes the production of ketones, which are byproducts of fat metabolism. Ketone bodies are a sub-category of three small organic molecules that are related to how the body processes fat. When there isn't enough blood sugar, the body breaks down stored fat. The result of fat breakdown can go through a pathway called the Krebs cycle or the citric acid cycle, which is usually used when burning sugars. However, due to the chemistry involved, there might not be the right chemical balance to run that cycle. For example, inside the liver, when it's trying to make more blood sugar through a process called gluconeogenesis, the products from breaking down fatty acids can be converted into ketone bodies.

The liver is the major production site of ketones. A reduction in glycogen in the liver increases ketones. Lowered glycogen levels make less glucose available for the liver to metabolise. As a result, oxaloacetate levels are down, and this lowers the activity within the Krebs cycle. This lowered activity, in turn, means lowered energy substrate processing, and this substrate is acetyl-CoA. The supply of acetyl-CoA is independent of its processing, so lowered processing raises its availability, and the increased level diverts the excess towards ketone body production.

The keto diet has been associated with an increased risk of kidney stones in some individuals. This is primarily due to the higher intake of animal proteins and lower intake of fruits and vegetables, which can affect urinary pH and mineral balance.

Vitamin and mineral imbalances

The keto diet is restrictive, which can lead to vitamin and mineral imbalances. These imbalances can affect urine colour and clarity.

Calcium

People on long-term keto diets can lose too much calcium in their urine, and the diet's high-fat content can increase the amount of acid generated by the body. This leads to lower urine pH, and calcium from bones is used to buffer the increased acid production, resulting in higher calcium loss in the urine and lower bone density.

Magnesium

Magnesium is another mineral that has been observed to decrease substantially on a long-term keto diet. This is likely due to eating fewer foods rich in magnesium, such as fruits and grains.

Iron

Even though keto diets usually involve eating a lot of meat, they also tend to reduce iron levels. Evidence suggests that this is due to reduced absorption of iron caused by high amounts of fat.

Sodium

The keto diet decreases insulin levels, which causes the body to expel more sodium than usual.

Potassium

Like sodium, potassium loss increases during the first few weeks on a keto diet and is partly responsible for flu-like symptoms.

Selenium

Research has found the keto diet decreases selenium levels and can cause deficiencies in the long run. High-fat foods tend to be low in selenium.

Carnitine

Carnitine is needed to burn fat, so it is used up much quicker on a keto diet. For most people, carnitine decreases temporarily during the first few months, but there is some research that shows deficiency may develop on long-term diets.

Urinary tract infections

Cloudy urine can be a symptom of a urinary tract infection (UTI), but it is not the only indicator. Urinary tract infections are bacterial infections that affect the urinary system, including the bladder, kidneys, ureters, and urethra. UTIs are common, especially in women, and can cause a range of uncomfortable symptoms.

Symptoms of UTIs

In addition to cloudy urine, other signs and symptoms of a UTI may include:

• Frequent urination
• A burning sensation during urination
• Pain or discomfort in the lower abdomen or back
• Strong-smelling or foul-smelling urine
• Blood in the urine
• Pelvic pain

Causes of UTIs

UTIs are usually caused by bacteria, typically E. coli, that enter the urinary tract through the urethra and begin to multiply in the bladder. Certain factors can increase the risk of developing a UTI, such as:

• Sexual intercourse: This can introduce bacteria into the urethra and bladder.
• Wiping back-to-front after using the toilet: This can transfer bacteria from the anal area to the urethra.
• Holding urine for too long: This can create an environment in the bladder that promotes bacterial growth.
• Dehydration: This can decrease the frequency of urination, allowing bacteria to multiply.
• Kidney stones: These can irritate the urinary tract and provide a surface for bacteria to attach to.

Treatment of UTIs

If you suspect you have a UTI, it is important to seek medical attention. A healthcare professional will typically perform a urine test to confirm the diagnosis and may prescribe antibiotics to clear the infection. Drinking plenty of water to flush out the bacteria and urinate more frequently is also recommended.

Prevention of UTIs

There are several ways to reduce the risk of developing a UTI:

• Drink plenty of water to stay hydrated and urinate frequently.
• Wipe front-to-back after using the toilet to prevent the spread of bacteria.
• Urinate when the need arises, rather than holding it for too long.
• Practice good sexual hygiene, such as urinating before and after intercourse.
• Avoid potentially irritating feminine products, such as douches and deodorant sprays.

Kidney stones

The keto diet has been associated with an increased risk of kidney stones in some individuals due to the higher intake of animal proteins and lower intake of fruits and vegetables, which can affect urinary pH and mineral balance. Eating a ketogenic diet can offer little fiber and significant amounts of animal-based proteins, which can aid in the hardening of stones in the kidneys. Additionally, the keto diet can increase the risk of dehydration, which is a risk factor for kidney stone formation.

To prevent kidney stones while on a keto diet, it is important to stay properly hydrated by drinking plenty of water and consuming hydrating foods such as cucumbers, watermelon, and leafy greens. It is also crucial to monitor sodium intake and aim for a cap of 2,300 mg per day. Consult with a healthcare professional if you have a history of kidney stones or are concerned about your kidney health before starting a keto diet.

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