Urobilinogen High In Urine – Symptoms, Conditions, And Management


Urobilinogen is a waste product formed as hemoglobin from dead red blood cells gets broken down. Some amount of urobilinogen appears in urine normally after being filtered out by the kidneys. However higher than normal levels can potentially indicate certain medical problems. 

Why Is Urobilinogen High In Urine?

Urobilinogen is a chemical compound produced when hemoglobin in aged red blood cells gets metabolized into bilirubin. Some urobilinogen gets excreted into bile and passed into stool. The remaining amount gets filtered by the kidneys into urine as a waste product.

Why Is Urobilinogen High In Urine

A urinalysis can detect the level of urobilinogen in urine through a simple dipstick test. Standard reference ranges define:

➜ Normal levels: Less than 1 mg/dL

➜ Increased levels: Greater than 1 mg/dL 

Elevated urobilinogen urine levels usually stem from one of three main underlying causes: liver disease, hemolytic anemia, or intestinal bleeding. Understanding the possible reasons for too much urobilinogen production helps diagnose medical conditions requiring treatment.

What Causes High Urobilinogen?

Here are the most common conditions associated with increased urine urobilinogen:

Liver Disease

Cirrhosis, hepatitis, and fatty liver decrease the liver’s ability to capture and metabolize bilirubin and urobilinogen from circulation. This allows more to be excreted into the urine.

Hemolytic Anemia

Conditions where red blood cells are broken down rapidly like sickle cell anemia or autoimmune hemolytic anemia increase bilirubin and urobilinogen production beyond the liver’s processing capacity.

Intestinal Bleeding 

Bleeding disorders like ulcers, polyps, diverticulitis, hemorrhoids, or cancer allow blood to enter the GI tract. Bacteria convert blood into urobilinogen that gets absorbed and passed into urine.

Biliary Obstruction

Blockages prevent bile from entering the intestines normally, causing urobilinogen to build up systemically until the kidneys filter it out.

Kidney Disease

Damaged kidneys have a lower capacity to capture and reabsorb urobilinogen into circulation, increasing how much spills into the urine.


Iron overload from this condition can damage liver cells, reducing urobilinogen processing.


Toxins and byproducts of alcohol metabolism overwhelm the liver and limit its ability to adequately process waste products like urobilinogen.

Diagnosing The Cause Of High Urobilinogen

If urine analysis shows elevated urobilinogen, doctors will perform more tests and assessments to determine the underlying reason:

  • Liver function blood tests to check for liver disease
  • Complete blood count to detect hemolytic anemia 
  • Kidney function tests to assess renal status
  • Fecal occult blood test to check for intestinal bleeding
  • Imaging like ultrasound, CT, or MRI to identify structural abnormalities  
  • Review of medications, supplements, and alcohol use
  • Evaluation of symptoms like jaundice, itching, pale stools, dark urine, nausea, fatigue, or unexplained weight changes
  • Pinpointing the root cause then guides appropriate treatment.

What Does High Urobilinogen Mean?

In general, increased urine urobilinogen signifies:

– Excess bilirubin and hemoglobin metabolism byproducts are being produced 

– The liver is unable to fully capture and process these waste products, allowing more to be excreted into urine

– There is likely some degree of liver dysfunction or damage present

– Increased red blood cell breakdown or intestinal bleeding may also be overloading the liver

– Kidney impairment may be limiting urobilinogen reabsorption 

Significantly elevated levels indicate a major disruption in normal urobilinogen waste elimination. Mildly increased levels suggest more subtle dysfunction requiring further investigation.

How To Reduce High Urobilinogen Levels?

Remedying the underlying condition is key to resolving abnormal urobilinogen levels long-term:

– Treating liver disease – Stopping alcohol use, medications, or hepatitis therapy

– Managing hemolytic anemia – Treating autoimmune disorders, malaria, blood cell abnormalities

– Controlling bleeding disorders – Medication, endoscopy procedures, or transfusions 

– Improving kidney function – Controlling diabetes and hypertension

– Relieving obstructions – Surgery or stenting procedures

– Correcting nutritional deficiencies – Iron, folate, or B12 supplementation

– Reducing iron overload – Phlebotomy or chelation therapy

Lifestyle measures like a healthful diet, exercise, hydration, and limiting alcohol also support organ function.

Can Urobilinogen Levels Be Too Low?  

Rarely, decreased or absent urine urobilinogen may occur. This usually results from:

– Severe liver failure unable to process bilirubin into urobilinogen 

– Biliary obstruction preventing elimination into a stool

– Certain antibiotic therapies killing GI flora required to convert urobilinogen 

Unless related to end-stage liver disease, low urobilinogen does not have severe clinical ramifications. However, it can help pinpoint the cause of concurrent jaundice if present.

When To See A Doctor?

Consult your physician if you experience any of the following possible signs of excessive urobilinogen:

➜ Yellowing skin or eyes

➜ Severe itching with no rash

➜ Abdominal swelling or fluid buildup

➜ Dark urine or light/clay-colored stool  

➜ Fatigue, nausea, poor appetite  

➜ Unexplained weight loss

➜ Fever or vomiting 

Muscle cramps

Catching concerning symptoms early helps initiate prompt treatment for the underlying disorder causing abnormal urobilinogen excretion.


Some urobilinogen in urine is normal, but elevated levels usually indicate impaired bilirubin processing due to liver dysfunction or high heme turnover. A urinalysis coupled with a thorough workup helps diagnose causes like hepatitis, cirrhosis, anemia, intestinal bleeding, or obstruction that require treatment. With proper medical management, urobilinogen levels can serve as a useful indicator of therapeutic progress, since levels should fall back into normal ranges when the underlying condition improves.


1. What foods reduce urobilinoge

Limiting fried or fatty foods, processed sugars, and alcohol helps reduce toxin burdens on the liver. Emphasize vegetables, fruits, lean proteins, whole grains and nuts to provide micronutrients that support detoxification systems.

2. What home remedies reduce urobilinogen?

There are no proven home remedies to directly lower urobilinogen. But supporting your body’s natural detoxification process through diet, hydration, exercise, and stress management may help. 

3. Can dehydration cause high urobilinogen

Yes, becoming dehydrated concentrates urine, allowing more urobilinogen to be detected. Ensure you are well hydrated before doing a urine test to prevent false elevations.

4. Does high urobilinogen mean cancer?

Not necessarily. More often, it indicates liver disease, anemia, or bleeding. But certain GI, kidney, and liver cancers could potentially be associated with increased urobilinogen excretion depending on cancer effects. Other testing would confirm cancer.

5. Can UTI cause high urobilinogen?

A UTI itself does not directly affect urobilinogen levels. But a UTI could cause microscopic bleeding which might contribute to increased urobilinogen production. Concurrent UTI and high urobilinogen warrant further medical investigation.

Dr. Jun Ren is a dedicated and experienced registered dietitian and nutritionist who is committed to helping people achieve their health goals through personalized nutrition plans. With a passion for promoting healthy eating habits and preventing chronic diseases, Dr. Ren has been able to assist numerous clients in improving their overall quality of life.

Leave a Comment