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Hello, I Am An Italian Guy, I Live In Italy.

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Posted on Sat, 22 Jun 2019
Question: Hello,
I am an Italian guy, I live in Italy. I am 32 years old, 1.77m 58kg.
I am writing here because I am very worried about one condition that has entetered my life.

I am experiencing an unpleasant symptom since the late December.
I try to describe it in the most comprehensive way I could.

When I urinate I feel as if my body leaks what I ate in the urine because I can smell very strongly the odour of foods I consume.
This is not a soft scent, that's why I smelt it the first time till now.
It happens this way : when I urinate, the first half of urine is fragrance free. It all starts in the second half of urination : the smell of food starts strongly, it can last from a few seconds to till the end of urination.

My urine was always scent and odour free, of course I could smell a urine odour sometimes in my life, but it was perfectly normal to me.
In this case I perceive it's not so normal. It isn't a typical odour or urine nor ammonia scent. It's strong food scent.

Some points I want to clarify:

I do drink 2+ liters of water a day so I am not dehydrated. Quite the contrary : the more I drink and the more the urination lasts the more the symptom lasts. I do not find a connection between fluid intake and any variation in the symptom.
I do not eat asparagus nor I drink coffee.
I do not eat junk foods.
I do not take any medications nor B vitamin supplements.
I do not have diabetes, my fasting blood glucose is 88.
I did urinalysis: negative. There was only "flora batterica +" and "presenza di muco" (i don't know how to translate it in English, but doctor said it is not a sign of infection.

If I eat fruit, my urine is strongly sweet. If I eat cereals (whole grains) I smell a strong flour scent.
If I eat tuna, I smell clearly and strongly tuna. If I eat pasta my urine gets more sweet, but not so sweet as if I eat fruits.
If I eat rice I smell starch in the same way. The same thing happens with vegetables.
This is not pleasant to smell. Sometimes the odor is very strong, even if I drank tons of water throughout the day.
It is like something pass through my urine.

The only thing I feel to report is that I ate a lots of protein though diet last year (not supplements) along with a strong muscle training, and muscular mass grew a bit.
I gained 4-5kg of muscle mass. I am a very thin guy, with very fast metabolism so it is very hard for me to gain mass.
My creatinine level XXXXXXX from 0 94 to 1,23, and I was very worried about it.
I visited a couple of nephrologists that gave me the response that everything was fine. They prescribed me with the following blood and urine tests :

Blood
Urea 28
Creatinin 1,18
Glucose 88
Uric acid 6.6
Indirect billiburin 1.5

Urine
24h proteinuria: 0,03 [normal range 0,01 - 0,1]
Albumin 24h: 3 [normal range 0 - 20]

Now, since the end of March I stopped my training and since January I reduced the intake of protein, and my creatinine lowered to 1, 20 then to 1,18 (I checked it on May).

Nephrologists said the creatinine will keep lowering month by month, they reassured me, but they could not answer about my symptom described above.
It happened one month later I reduced protein intake.
They said in their opinion it is not related to renal function nor to kidneys, otherwise I would have had some value out of the range.
First of all : is it true that my creatinine level should lower in several months than lower immediately? For example, my previous blood urea and uric acid were :

Urea 44
Uric acid 7. 4

And they lowered to 28 and 6.6 almost immediately with sudden change in protein intake. Creatinine has lowered only to 1.18.

My creatinine levels throughout my life were about 0,90-1, never been above that before this period of training.

But I am very worried, because my doctors couldn't answer me. But the symptom is concrete, present all day every day and not opinable.
If this is not a symptom a doctor can find in a book, it's not my fault, but the symptom does exist.

So, in my last resort,I'm writing here in the hope to overcome the problem.

I wanted to know your response about it and how I can resolve this.

Could it be that some of the particles of the food I eat leak in my urine?
Could it be that my kidneys fail to filter these components?
Could it be that my kidneys are overactive because I reduced protein intake but still work as if it was high?

I don't know what to think and I feel very bad about it.

I am worried because I think it could become something more serious, and because doctors said they don't understand why.

I would really appreciate your response, because I am very worried and I see that I doesn't go away but it is present.
I am starting to fear what I eat because I smell it strongly in my urine, and it is very difficult for me.

Thank you in advance.
default
Follow up: Dr. AJEET SINGH (0 minute later)
Hello,
I am an Italian guy, I live in Italy. I am 32 years old, 1.77m 58kg.
I am writing here because I am very worried about one condition that has entetered my life.

I am experiencing an unpleasant symptom since the late December.
I try to describe it in the most comprehensive way I could.

When I urinate I feel as if my body leaks what I ate in the urine because I can smell very strongly the odour of foods I consume.
This is not a soft scent, that's why I smelt it the first time till now.
It happens this way : when I urinate, the first half of urine is fragrance free. It all starts in the second half of urination : the smell of food starts strongly, it can last from a few seconds to till the end of urination.

My urine was always scent and odour free, of course I could smell a urine odour sometimes in my life, but it was perfectly normal to me.
In this case I perceive it's not so normal. It isn't a typical odour or urine nor ammonia scent. It's strong food scent.

Some points I want to clarify:

I do drink 2+ liters of water a day so I am not dehydrated. Quite the contrary : the more I drink and the more the urination lasts the more the symptom lasts. I do not find a connection between fluid intake and any variation in the symptom.
I do not eat asparagus nor I drink coffee.
I do not eat junk foods.
I do not take any medications nor B vitamin supplements.
I do not have diabetes, my fasting blood glucose is 88.
I did urinalysis: negative. There was only "flora batterica +" and "presenza di muco" (i don't know how to translate it in English, but doctor said it is not a sign of infection.

If I eat fruit, my urine is strongly sweet. If I eat cereals (whole grains) I smell a strong flour scent.
If I eat tuna, I smell clearly and strongly tuna. If I eat pasta my urine gets more sweet, but not so sweet as if I eat fruits.
If I eat rice I smell starch in the same way. The same thing happens with vegetables.
This is not pleasant to smell. Sometimes the odor is very strong, even if I drank tons of water throughout the day.
It is like something pass through my urine.

The only thing I feel to report is that I ate a lots of protein though diet last year (not supplements) along with a strong muscle training, and muscular mass grew a bit.
I gained 4-5kg of muscle mass. I am a very thin guy, with very fast metabolism so it is very hard for me to gain mass.
My creatinine level XXXXXXX from 0 94 to 1,23, and I was very worried about it.
I visited a couple of nephrologists that gave me the response that everything was fine. They prescribed me with the following blood and urine tests :

Blood
Urea 28
Creatinin 1,18
Glucose 88
Uric acid 6.6
Indirect billiburin 1.5

Urine
24h proteinuria: 0,03 [normal range 0,01 - 0,1]
Albumin 24h: 3 [normal range 0 - 20]

Now, since the end of March I stopped my training and since January I reduced the intake of protein, and my creatinine lowered to 1, 20 then to 1,18 (I checked it on May).

Nephrologists said the creatinine will keep lowering month by month, they reassured me, but they could not answer about my symptom described above.
It happened one month later I reduced protein intake.
They said in their opinion it is not related to renal function nor to kidneys, otherwise I would have had some value out of the range.
First of all : is it true that my creatinine level should lower in several months than lower immediately? For example, my previous blood urea and uric acid were :

Urea 44
Uric acid 7. 4

And they lowered to 28 and 6.6 almost immediately with sudden change in protein intake. Creatinine has lowered only to 1.18.

My creatinine levels throughout my life were about 0,90-1, never been above that before this period of training.

But I am very worried, because my doctors couldn't answer me. But the symptom is concrete, present all day every day and not opinable.
If this is not a symptom a doctor can find in a book, it's not my fault, but the symptom does exist.

So, in my last resort,I'm writing here in the hope to overcome the problem.

I wanted to know your response about it and how I can resolve this.

Could it be that some of the particles of the food I eat leak in my urine?
Could it be that my kidneys fail to filter these components?
Could it be that my kidneys are overactive because I reduced protein intake but still work as if it was high?

I don't know what to think and I feel very bad about it.

I am worried because I think it could become something more serious, and because doctors said they don't understand why.

I would really appreciate your response, because I am very worried and I see that I doesn't go away but it is present.
I am starting to fear what I eat because I smell it strongly in my urine, and it is very difficult for me.

Thank you in advance.
doctor
Answered by Dr. AJEET SINGH (28 minutes later)
Brief Answer:
Urine odour

Detailed Answer:
Hi.
Welcome to Ask a doctor.
I am Dr Ajeet XXXXXXX

Firstly,the gastrointestinal tract and urogenital system of our body are absolutely different.
Food can't leak in urine.
The food we eat,gets digested and assimilated in gut and nutrients are absorbed in blood. Residue is excreted out as stools.
Blood is filtered by urine and waste products are removed in urine.
In no way,food can pass in urine.

Your creatinine levels are normal and your kidneys are working well.It is not that a high normal value is bad and a low normal is good.
Creatinine depends on the changes in muscle mass,amount of protein intake,hydration state,BMR and metabolic state of body(anabolic/catabolic).It is just a number and you need not follow it that closely.

Commonest cause of abnormal odour of urine is a urinary tract infection and that has been proven in your urinalysis report (Bacterial flora+).This requires a urine culture and suitable antibiotic course.

Hope that I have answered your query.
Stay healthy and stay blessed
Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
Urine odour

Detailed Answer:
Hi.
Welcome to Ask a doctor.
I am Dr Ajeet XXXXXXX

Firstly,the gastrointestinal tract and urogenital system of our body are absolutely different.
Food can't leak in urine.
The food we eat,gets digested and assimilated in gut and nutrients are absorbed in blood. Residue is excreted out as stools.
Blood is filtered by urine and waste products are removed in urine.
In no way,food can pass in urine.

Your creatinine levels are normal and your kidneys are working well.It is not that a high normal value is bad and a low normal is good.
Creatinine depends on the changes in muscle mass,amount of protein intake,hydration state,BMR and metabolic state of body(anabolic/catabolic).It is just a number and you need not follow it that closely.

Commonest cause of abnormal odour of urine is a urinary tract infection and that has been proven in your urinalysis report (Bacterial flora+).This requires a urine culture and suitable antibiotic course.

Hope that I have answered your query.
Stay healthy and stay blessed
Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. AJEET SINGH (1 hour later)
The "bacterial flora+" and mucus appears and disappears, it has appeared 3times and disapperead.
I have made the urine culture 2 times but it tested negative.

The problem is that two nephrologists said nothing to me about bacterial flora, maybe due to urineculture
negativity.
So how can I tell a doctor to give me antibiotcs if he didn't tell me anything about?

I read from a medical wesite that

"In healthy persons, the glomerular capillary wall is permeable
only to substances with a molecular weight of less than 20,000 Daltons"
Could it be that my glomerular capillary wall is involved?

Because the strong odour I smell is always related to the food I eat.Even if I eat white rice only I smell
"sweet/starch". The odour changes if food changes (again, no asparagus nor other common culprits), but the urine
is no more odorless or scent free no more, no matter what I eat.
Could this be related to pancreatic enzymes? Infections? Are there some tests I could do in addition to what
have already done?

I am strongly sure that there's something wrong about it.
default
Follow up: Dr. AJEET SINGH (0 minute later)
The "bacterial flora+" and mucus appears and disappears, it has appeared 3times and disapperead.
I have made the urine culture 2 times but it tested negative.

The problem is that two nephrologists said nothing to me about bacterial flora, maybe due to urineculture
negativity.
So how can I tell a doctor to give me antibiotcs if he didn't tell me anything about?

I read from a medical wesite that

"In healthy persons, the glomerular capillary wall is permeable
only to substances with a molecular weight of less than 20,000 Daltons"
Could it be that my glomerular capillary wall is involved?

Because the strong odour I smell is always related to the food I eat.Even if I eat white rice only I smell
"sweet/starch". The odour changes if food changes (again, no asparagus nor other common culprits), but the urine
is no more odorless or scent free no more, no matter what I eat.
Could this be related to pancreatic enzymes? Infections? Are there some tests I could do in addition to what
have already done?

I am strongly sure that there's something wrong about it.
doctor
Answered by Dr. AJEET SINGH (4 hours later)
Brief Answer:
Urinary odour

Detailed Answer:
There are two ultimate tests to know about the filtration capacity and efficiency of kidneys.

Number one is urine Test called ACR (albumin-to-creatinine ratio).
Albumin is a plasma protein in the blood but not the urine.It has a molecular size big enough,not to be filtered by kidneys.Having albumin protein in urine means that kidneys are not filtering the blood well enough.This can even detect an impending and subclinical kidney disease.If urine test comes “positive” for protein, the test should be repeated to confirm the results.Three positive results over three months or more is a sign of kidney disease.

There is another blood test to estimate your GFR (eGFR).Your blood will be tested for a waste product called creatinine which is removed from the blood by the kidneys into the urine.When the kidneys are damaged, they can't remove creatinine properly and it's level in blood rises.Testing for creatinine is only the first step.The creatinine result is used in a math formula with age, race, and sex to find out your glomerular filtration rate (GFR). Your GFR number tells how well your kidneys are working.

Check with your doctor about having these ultimate tests and revert.
Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
Urinary odour

Detailed Answer:
There are two ultimate tests to know about the filtration capacity and efficiency of kidneys.

Number one is urine Test called ACR (albumin-to-creatinine ratio).
Albumin is a plasma protein in the blood but not the urine.It has a molecular size big enough,not to be filtered by kidneys.Having albumin protein in urine means that kidneys are not filtering the blood well enough.This can even detect an impending and subclinical kidney disease.If urine test comes “positive” for protein, the test should be repeated to confirm the results.Three positive results over three months or more is a sign of kidney disease.

There is another blood test to estimate your GFR (eGFR).Your blood will be tested for a waste product called creatinine which is removed from the blood by the kidneys into the urine.When the kidneys are damaged, they can't remove creatinine properly and it's level in blood rises.Testing for creatinine is only the first step.The creatinine result is used in a math formula with age, race, and sex to find out your glomerular filtration rate (GFR). Your GFR number tells how well your kidneys are working.

Check with your doctor about having these ultimate tests and revert.
Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. AJEET SINGH (10 hours later)
I have done albumin in urine as I said in my previous post.
Result : 3 [normal range 0-20] negative

My gfr is 81. It improved from 77 because the creatinine has lowered.

What I want to know is if this symptom is a sign of kidney disfunction, even if the values are in normal range. Or what it could be. Because it is concrete and tangible, and my urine was previously always scent free.
default
Follow up: Dr. AJEET SINGH (0 minute later)
I have done albumin in urine as I said in my previous post.
Result : 3 [normal range 0-20] negative

My gfr is 81. It improved from 77 because the creatinine has lowered.

What I want to know is if this symptom is a sign of kidney disfunction, even if the values are in normal range. Or what it could be. Because it is concrete and tangible, and my urine was previously always scent free.
doctor
Answered by Dr. AJEET SINGH (1 hour later)
Brief Answer:
Creatinine values

Detailed Answer:
Hi..

Your kidney functions are normal as your urea and creatinine are fine so a kidney disease has been ruled out.
There is no high normal or low normal values of creatinine.It is a range.Everything that falls in this range is normal.It is just a number which is not abnormal for you and you need not follow it that closely.Don't over think and please de stress yourself.

Creatinine values depends on multiple factors.
If you do an intense workout,It will increase.

Low creatinine can be due to decreased muscle mass,liver diseases,diet,pregnancy or prolonged illness too

Creatinine levels are linked to total muscle mass of the body, which can decrease with age or illness.People lose some muscle mass with age, and this is not usually a serious medical concern.

Creatine is excreted in urine but produced in the liver, and an unhealthy liver will not be able to make the normal amounts.

A small amount of creationine comes from food we eat so low levels of creatinine could relate to diet.
Creatine is mostly found in red meat, so those who are vegetarians or people taking low-protein diet would have lower levels than people who are nonvegetarians or eat high protein diet.

A prolonged fasting can be another cause of low levels of creatinine.
Now coming to your smelly urine....

Normally Urine odor varies and most of the time,it doesn't have a strong smell if a person is healthy
and hydrated.

Most urine smells are not a sign of disease and go away in time.

Some foods like asparagus and some medicines, like vitamins and antibiotics may affect your urine's odor.

First differential diagnosis for it would be an infection usually by a bacteria.

Sweet-smelling urine may be a sign of uncontrolled diabetes or a rare congenital disease of metabolism.

Some liver disease and certain metabolic disorders may cause musty urine.

If body is dehydrated,concentrated urine smells like ammonia.

Chlamydia is a known sexually transmitted disease that can cause cloudy, smelly urine due to pus but is difficult to diagnose.
Chlamydia may be contracted by unprotected vaginal, anal, or oral sex.

A gastrointestinal-bladder fistula is an abnormal connection between the intestines and bladder and it can lead to the food smell which you are describing.

Maple syrup urine disease is a rare genetic disease
called Phenylketonuria in which the urine has sweet smell.

Porphyria is a metabolic disturbance which can be diagnosed by urine porphobilinogen test.

Please let me know if I can be of any further help.
Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
Creatinine values

Detailed Answer:
Hi..

Your kidney functions are normal as your urea and creatinine are fine so a kidney disease has been ruled out.
There is no high normal or low normal values of creatinine.It is a range.Everything that falls in this range is normal.It is just a number which is not abnormal for you and you need not follow it that closely.Don't over think and please de stress yourself.

Creatinine values depends on multiple factors.
If you do an intense workout,It will increase.

Low creatinine can be due to decreased muscle mass,liver diseases,diet,pregnancy or prolonged illness too

Creatinine levels are linked to total muscle mass of the body, which can decrease with age or illness.People lose some muscle mass with age, and this is not usually a serious medical concern.

Creatine is excreted in urine but produced in the liver, and an unhealthy liver will not be able to make the normal amounts.

A small amount of creationine comes from food we eat so low levels of creatinine could relate to diet.
Creatine is mostly found in red meat, so those who are vegetarians or people taking low-protein diet would have lower levels than people who are nonvegetarians or eat high protein diet.

A prolonged fasting can be another cause of low levels of creatinine.
Now coming to your smelly urine....

Normally Urine odor varies and most of the time,it doesn't have a strong smell if a person is healthy
and hydrated.

Most urine smells are not a sign of disease and go away in time.

Some foods like asparagus and some medicines, like vitamins and antibiotics may affect your urine's odor.

First differential diagnosis for it would be an infection usually by a bacteria.

Sweet-smelling urine may be a sign of uncontrolled diabetes or a rare congenital disease of metabolism.

Some liver disease and certain metabolic disorders may cause musty urine.

If body is dehydrated,concentrated urine smells like ammonia.

Chlamydia is a known sexually transmitted disease that can cause cloudy, smelly urine due to pus but is difficult to diagnose.
Chlamydia may be contracted by unprotected vaginal, anal, or oral sex.

A gastrointestinal-bladder fistula is an abnormal connection between the intestines and bladder and it can lead to the food smell which you are describing.

Maple syrup urine disease is a rare genetic disease
called Phenylketonuria in which the urine has sweet smell.

Porphyria is a metabolic disturbance which can be diagnosed by urine porphobilinogen test.

Please let me know if I can be of any further help.
Regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
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Dr. AJEET SINGH

General & Family Physician

Practicing since :1994

Answered : 2151 Questions

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Hello, I Am An Italian Guy, I Live In Italy.

Hello, I am an Italian guy, I live in Italy. I am 32 years old, 1.77m 58kg. I am writing here because I am very worried about one condition that has entetered my life. I am experiencing an unpleasant symptom since the late December. I try to describe it in the most comprehensive way I could. When I urinate I feel as if my body leaks what I ate in the urine because I can smell very strongly the odour of foods I consume. This is not a soft scent, that's why I smelt it the first time till now. It happens this way : when I urinate, the first half of urine is fragrance free. It all starts in the second half of urination : the smell of food starts strongly, it can last from a few seconds to till the end of urination. My urine was always scent and odour free, of course I could smell a urine odour sometimes in my life, but it was perfectly normal to me. In this case I perceive it's not so normal. It isn't a typical odour or urine nor ammonia scent. It's strong food scent. Some points I want to clarify: I do drink 2+ liters of water a day so I am not dehydrated. Quite the contrary : the more I drink and the more the urination lasts the more the symptom lasts. I do not find a connection between fluid intake and any variation in the symptom. I do not eat asparagus nor I drink coffee. I do not eat junk foods. I do not take any medications nor B vitamin supplements. I do not have diabetes, my fasting blood glucose is 88. I did urinalysis: negative. There was only "flora batterica +" and "presenza di muco" (i don't know how to translate it in English, but doctor said it is not a sign of infection. If I eat fruit, my urine is strongly sweet. If I eat cereals (whole grains) I smell a strong flour scent. If I eat tuna, I smell clearly and strongly tuna. If I eat pasta my urine gets more sweet, but not so sweet as if I eat fruits. If I eat rice I smell starch in the same way. The same thing happens with vegetables. This is not pleasant to smell. Sometimes the odor is very strong, even if I drank tons of water throughout the day. It is like something pass through my urine. The only thing I feel to report is that I ate a lots of protein though diet last year (not supplements) along with a strong muscle training, and muscular mass grew a bit. I gained 4-5kg of muscle mass. I am a very thin guy, with very fast metabolism so it is very hard for me to gain mass. My creatinine level XXXXXXX from 0 94 to 1,23, and I was very worried about it. I visited a couple of nephrologists that gave me the response that everything was fine. They prescribed me with the following blood and urine tests : Blood Urea 28 Creatinin 1,18 Glucose 88 Uric acid 6.6 Indirect billiburin 1.5 Urine 24h proteinuria: 0,03 [normal range 0,01 - 0,1] Albumin 24h: 3 [normal range 0 - 20] Now, since the end of March I stopped my training and since January I reduced the intake of protein, and my creatinine lowered to 1, 20 then to 1,18 (I checked it on May). Nephrologists said the creatinine will keep lowering month by month, they reassured me, but they could not answer about my symptom described above. It happened one month later I reduced protein intake. They said in their opinion it is not related to renal function nor to kidneys, otherwise I would have had some value out of the range. First of all : is it true that my creatinine level should lower in several months than lower immediately? For example, my previous blood urea and uric acid were : Urea 44 Uric acid 7. 4 And they lowered to 28 and 6.6 almost immediately with sudden change in protein intake. Creatinine has lowered only to 1.18. My creatinine levels throughout my life were about 0,90-1, never been above that before this period of training. But I am very worried, because my doctors couldn't answer me. But the symptom is concrete, present all day every day and not opinable. If this is not a symptom a doctor can find in a book, it's not my fault, but the symptom does exist. So, in my last resort,I'm writing here in the hope to overcome the problem. I wanted to know your response about it and how I can resolve this. Could it be that some of the particles of the food I eat leak in my urine? Could it be that my kidneys fail to filter these components? Could it be that my kidneys are overactive because I reduced protein intake but still work as if it was high? I don't know what to think and I feel very bad about it. I am worried because I think it could become something more serious, and because doctors said they don't understand why. I would really appreciate your response, because I am very worried and I see that I doesn't go away but it is present. I am starting to fear what I eat because I smell it strongly in my urine, and it is very difficult for me. Thank you in advance.