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What causes cloudy yellow urine?

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Internal Medicine Specialist
Practicing since : 1999
Answered : 3148 Questions
2 questions... Just curious, in the morning my urine is usually cloudy and bright yellow. The yellow part appears oily and sinks to the bottom. What could cause this?

Second question... I drink about a gallon of water a day and a glass of ice tea at night. I know I mentioned above about the mornings but after my first pee in the morning occasionally my urine has a oily bright yellow that sinks to the bottom. It’s not cloudy after my first pee. What could cause the oily sinking bright urine?

I do take hydrocodone for my back. I take 3 10/325 a day. Also, I had a cat scan on my abdomen, as well as a ton of blood work this year. Including 3 egfr (I think they are called) , liver panels, and I have peed in a cup 4 different times this year. All my blood work, cat scans, and urine samples have been normal. All my kidney and liver functions are normal. So I’m curious what could cause both situations? Maybe the hydrocodone? The only blood work that has been off is raised ferritin levels. Any thoughts
Posted Fri, 24 Nov 2017 in Urinary and Bladder Problems
Answered by Dr. Panagiotis Zografakis 6 hours later
Brief Answer:

Detailed Answer:

since everything has been normal, I can only guess that your urine has a lot of crystals (which is not a finding that would draw significant attention at it). Crystals may cause a cloudy appearance and they tend to sink to the the bottom. Lipiduria would have been another concern but your normal tests rule it out. I don't know of any side effect like that caused by hydrocodone so I can't confirm your suspicion.

Ketonuria may also be a potential cause particularly in the morning (dehydration, fasting).

Raised ferritin levels are usually caused by liver issues (alcohol consupmtion, fatty liver, etc). Sometimes iron overload may be the cause but ferritin levels tend to rise more. Checking iron, total iron binding capacity and ferritin at the same time may help to get more information.

I hope you find my comments helpful!
Kind Regards!
Above answer was peer-reviewed by
Follow-up: What causes cloudy yellow urine? 3 hours later
Very helpful, would any of those test help determine any of this things u mentioned above? Or should I ask them for a different test?
Answered by Dr. Panagiotis Zografakis 2 hours later
Brief Answer:
read the full answer for the tests...

Detailed Answer:
A urinalysis with microscopic examination of the urine is enough to detect crystals. Ketones positivity should be indicated on the specimen. If you don't have proteins in your urine then I wouldn't worry too much about it...

Regarding your ferritin, an ultrasound scan of the liver and serum iron, total iron binding capacity (TIBC) and ferritin levels should be enough for an initial evaluation of iron overload and other potential causes of ferritin elevation.

Kind Regards!
Above answer was peer-reviewed by
Follow-up: What causes cloudy yellow urine? 30 hours later
Thank u again. I had a ultrasound, nuclear liver and spleen scan as well as a cat scan of the abdomen with in the past 7 months. All normal. My tibc, iron, and saturation % were all normal. All my globulins, lft’s, and all my other liver blood work were normal as well. Just a raised ferritin. So I don’t know
Answered by Dr. Panagiotis Zografakis 16 hours later
Brief Answer:
nothing to worry about then!

Detailed Answer:
You're welcome!

It seems that you've been through extensive testing and no disorder was detected. This is good news! The ferritin levels cannot - obviously - be fully explained since you don't have any symptoms or findings (including the negative tests). Not everyone has the same ferritin though, so it could be YOUR ferritin levels. If you develop any symptoms you should check again in the future though.

Kind Regards!
Above answer was peer-reviewed by
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