This article discusses about a pathological condition in which an individual passes urine that is red or pink in color after ingesting beetroot or other dye containing food. This article discusses about the various causes of Beeturia, and its symptoms, how long does it last, and how can one differentiate between urine discoloration due to Beeturia and real blood in the urine. Beeturia is observed in 14% humans.1
How Is Beeturia Defined?
- Beeturia, as stated, is passing red or pink urine after ingesting beetroot or other foods which have been colored with extracts of beetroot or beetroot pigments.2
- The red or pink color of the urine is caused by excretion of a pigment called betanin.
- The discoloration of urine varies appreciably from individual to individual and can be from barely visible to extremely strong.
- Betanin is sensitive to oxidative degradation in the setting of strong acidic condition. Therefore, discoloration of urine depends on the amount of acid content present in the stomach as well as presence of protecting substances like oxalic acid.
- Beeturia is also associated with red or pink stools.
Causes of Beeturia
- A pigment called betanin, which is present in beetroot, causes the red coloration of the urine observed with Beeturia. When it passes through the body it causes a red tinge to the urine
- Beeturia is the word that came from Beet and Urea.
- Diagnosis of Beeturia suggests excretion of red beetroot pigment (betalaine) in urine and feces.
- Urinary excretion of betalaine results following colonic absorption of betalaine.
- Betalaine is the indicator, which is decolorized by hydrochloric acid, ferric ions and colonic bacteria.
- Pigment betacyanins is unstable in acid conditions. The metabolic reaction of betacyanin pigment is determined largely by gastric pH and emptying rate.
- Beeturia is more common in iron deficiency and Malabsorption syndrome.
Symptoms of Beeturia
Beeturia is not a harmful medical condition but the red tinged urine that comes with it can be a sign of some other problem with the kidneys and hence if an individual develops Beeturia then that individual needs to consult a physician and have a urinalysis done to rule out other potential causes of red colored urine.
- Beeturia- The main symptom of Beeturia is red or pink colored urine after eating beetroots or foods containing beetroot extracts and pigments.
- History of Malabsorption- Patient may give history of bulky and frequent stools. History may suggest constipation, stomach bloating and flatulence. Betacynin pigment may be absorbed and discharged in urine resulting in pink discoloration of urine.
- Absence Of Blood In Urine- Patient may think the urine contains blood and initial clinical diagnosis may be hematuria. Urine examination indicates negative test for red blood cells and blood.
- Differential Diagnosis- Clinical examination and lab studies are done to rule out causes of urine discoloration.
Diagnosis Of Beeturia
Lab test is performed to rule out all diseases, which may be causing urine discoloration.
Blood Examination for Beeturia
- Complete Blood Count-
- Check for low red blood cells to rule out anemia and hematuria
- Check hemoglobin to rule out anemia and hematuria.
Urine Examination for Beeturia
- Check for blood, red blood cells and bacteria in urine to rule out hematuria
- Check for BUN and creatinine to evaluate kidney function
Stool Examination for Beeturia
- Examine stool for any blood discharge.
Ultrasound Study for Beeturia
- Test is indicted to check the development of kidney and rule out any kidney anomalies.
- If all the tests come back normal, then it can be said with certainty that the urine discoloration is caused due to Beeturia
Treatment for Beeturia
- Increase water intake for 2 to 5 days to wash out the pigment. Examine urine color daily.
- Discontinue iron pills for 7 to 10 days. Beeturia has no connection with iron absorption."
Fruits or Beetroot Consumption-
- Beeturia usually lasts for a couple of days and resolves.
- The time limit is variable and is different for different people.
- It is also dependent on the amount of fluids an individual drinks
- Continuous intake of beetroot and fruits may continue with discoloration of urine.
How Can An Individual Differentiate Between Beeturia And Real Blood In The Urine/Stools?
Differentiation between fresh blood and Beeturia-
- Blood on toilet paper in its purest form will be bright red in color.
- Beeturia juice is very diffuse and creates a reddish-purple color.
1. Beeturia and iron absorption.
QJM. 1995 Oct;88(10):711-7.
Lancet. 1999 Sep 18;354(9183):1032.
2. Beeturia and the biological fate of beetroot pigments.
Watts AR1, Lennard MS, Mason SL, Tucker GT, Woods HF.
Pharmacogenetics. 1993 Dec;3(6):302-11.