Your bathroom habits can tell you a lot of about your health. If you have dark yellow or cloudy urine, you’re probably dehydrated, and if you ate some asparagus earlier, smelly pee may ensue. But what about foamy urine? And if you notice bubbles in the toilet all of a sudden, is it a cause for concern?
‘After you urinate, a single layer of larger bubbles that disappears within a couple of minutes is considered normal,’ says Ana Claudia Onuchic-Whitford, MD, a nephrologist at Brigham and Women’s Hospital. ‘But ‘foamy’ urine is multiple layers of tiny to medium-sized bubbles in the toilet bowl that do not go away after a few minutes,’ she says. While bubbles are clear, foam is more of an opaque shade of white.
In some cases, foamy urine may be a sign of kidney issues, diabetes, or even blood cancer. However, it could also be something entirely simple, like how the urine hits the surface of the toilet or the bathroom cleaning products you used, says Vikas Desai, MD, a urologist at Delnor Hospital. If you’re concerned, here are eight potential reasons why you suddenly have foamy urine, and when to seek help, according to doctors.
Why is my urine foamy?
- You have a super-fast urine stream.
Yes, really. ‘Some amount of bubbles in the urine is normal,’ says Yaakov Liss, MD, a nephrologist at CareMount Medical in New York. ‘This can be affected by how fast the urinary stream is and how far the urine has to travel before hitting the toilet,’ he says.
FYI: A normal urinary stream flows at about 15 milliliters per second (not necessarily helpful information, but still interesting!)—so, if your pee looks a bit bubblier than usual, it might just be coming out a little faster, says Dr. Liss.
- You’re dehydrated.
Not drinking enough water can also make your urine foamy. ‘The more dehydrated someone is, the more concentrated their urine will be [as their body tries to] conserve water,’ says Dr. Liss. This results in foaminess because more substances are excreted in a smaller volume of water. If you spot foamy urine, a good first step is increasing your hydration to see if that helps.
Try drinking electrolyte beverages to hydrate and boost your salt levels, which tend to drop when you’re dehydrated, says Dr. Desai. Extreme dehydration can cause severe muscle aches, lightheadedness, confusion, dizziness, and/or trouble breathing. If you experience any of these symptoms, go to the hospital immediately, he adds.
- You could have kidney disease.
Healthy kidneys filter out waste from your blood while keeping protein and other important substances circulating in your bloodstream. Foamy pee is often a sign that there is protein in your urine, according to Northwestern Medicine, and in some cases, it could be a sign of kidney disease.
‘Under normal circumstances, the kidney filters do not permit protein molecules from the blood to pass through and end up in the urine,’ Dr. Liss says. ‘An increase of protein in the urine is generally evidence of a damaged and leaky kidney filter.’
Keep in mind that foamy urine is just one sign of a damaged kidney—other signs include swelling due to fluid retention and/or weight gain. Early chronic kidney disease often has no signs or symptoms, though—so if you suspect something is up, make an appointment with your doc to be on the safe side.
Your primary care provider can perform a simple urine test to determine whether protein is present in your pee and how much is there. Depending on the results and your medical history, they may refer you to a nephrologist, who can order blood work to pinpoint the exact cause and prescribe the appropriate treatment.
- You have diabetes or hypertension.
Protein in the urine is at play here once again. Both conditions—diabetes, which affects the body’s insulin levels; and hypertension (a.k.a. high blood pressure)—can affect blood flow to the kidneys, impairing their function.
‘This increased pressure [causes] increased stress, which leads to damage and protein in the urine,’ says Dr. Liss, which, again, can result in foaminess.
Both diabetes and hypertension have other symptoms, too—diabetes often comes with increased urination and thirst and hypertension can manifest as chest pain or shortness of breath. If you’re experiencing those symptoms along with foamy urine, let your doc know.
Diabetes and high blood pressure are often managed with oral medications. Following a healthy lifestyle including exercise, a healthy diet with lower sugar, calorie, and salt intake, and limited alcohol intake is also an important part of treatment for both diseases, adds Dr. Onuchic-Whitford.
- You have a chronic infection.
Chronic infections (like hepatitis or HIV) can also cause excess protein in your urine, says Dr. Liss. Some infections can directly attack the kidney filters while others cause inflammation that can affect your kidneys’ functioning.
‘For HIV, there are antivirals [as treatment] and you’ll work with an infectious disease doctor,’ says Dr. Desai. Your primary care physician can likely prescribe antiviral meds for hepatitis and you may be referred to a hepatologist for follow-up care.
If you’ve been battling a chronic illness and your urine looks soapy or sudsy, check with your doctor—a simply urine test can help your doc figure out what to do from there.
- It could be due to pain meds.
If you’ve been taking over-the-counter painkillers for a while and your urine is looking foamier than usual, those pills could be to blame. NSAIDs in particular (think: Advil, Motrin, and Aleve) can cause you to have high levels of protein in your urine, Dr. Liss says. Even worse: Sometimes those pain meds can result in an allergic reaction that causes inflammation in your kidneys.
It’s not a great idea to take any OTC painkillers for an extended period of time without medical supervision, so if you’ve been on a steady regimen of pills, check in with your doctor to make a long-term plan for pain management.
‘In these cases, it’s best to see a pain specialist who may be able to offer a nerve block depending on the source of the pain,’ says Dr. Desai. Physical therapy and rehab can also help with pain from injuries.
- You have an autoimmune disease.
Autoimmune conditions also put stress and strain on the kidneys, potentially causing enough damage to disrupt the filtering process. ‘Similar to [chronic viral infections], autoimmune conditions can lead to protein in the urine via the patient’s own immune system mistakenly attacking the patient’s own kidney filters,’ says Dr. Liss, who notes that these conditions can be exclusive to the kidneys or systemic, like lupus.
Symptoms of autoimmune conditions vary, but have several symptoms in common, like fatigue, joint pain, and recurring fever, for example. If you see foamy urine and you haven’t felt like yourself for a while, check in with your doctor. Treatment often includes steroids or other medications to suppress the immune system.
- You could have a type of blood cancer.
Multiple myeloma—a type of cancer that forms in the plasma cells of your blood—can lead to extra protein in the urine and cause it to look foamy. Antibodies that are produced as a result of the cancer ‘can be highly toxic to the kidney filters and lead to protein in the urine,’ according to Dr. Liss.
However, this situation is rare. Multiple myeloma is a relatively uncommon cancer most prevalent in men over 60 and is twice as common in black people compared to other ethnic groups, per the NHS. It’s probably not the first conclusion you should jump to if you have foamy urine, but depending on your age and race, it could be a possibility.
Other telltale symptoms of this condition include bone pain, nausea, constipation, loss of appetite, weight loss, confusion, and excessive thirst. Blood cancer is usually treated with a combination of chemotherapy, immunotherapy, corticosteroids and radiation therapy, per Mayo Clinic.
When should I be worried about foamy urine?
If foamy urine is a one time occurrence, experts say there’s no need to worry. That said, if you notice foamy urine every time you use the bathroom or it persists for several days to a week, you definitely want to get it checked out, says Dr. Desai.
‘If someone has foamy urine and other new or concerning symptoms like blood in the urine, pain when urinating, excessive fatigue, fevers, weight loss, swelling, shortness of breath, or persistent joint pain, they should contact their doctor immediately,’ notes Dr. Onuchic-Whitford. Additionally, if you’re pregnant, protein in the urine may indicate a serious condition called preeclampsia, and you should let your doctor know ASAP, she adds.
Content by: SARAH BRADLEY AND ANDI BREITOWICH
