The amount of ammonia in your urine gives it a distinct smell. But especially strong-smelling urine can be a sign of dehydration, liver disease, or pregnancy.

Urine has a natural odor that is unique to everyone. From time to time, you may notice that your urine occasionally has a stronger smell than it normally does. This isn’t always a cause for concern. But sometimes strong or unusual smelling urine is a sign of an underlying medical problem.

Read on to learn why urine may sometimes have a stronger odor.

Dehydration

One of the most common reasons for strong-smelling pee is dehydration.

Everyone’s urine has ammonia in it. The more hydrated you are, the less concentrated the ammonia is. But when you’re dehydrated, the ammonia concentration is stronger — and so is the smell. This is why you may notice your urine smells stronger in the morning right after you wake up.

Dark-colored urine is another sign of dehydration.

Staying hydrated is extremely important for overall health. Typically, by the time you feel thirsty, you’re already a bit dehydrated, so stay ahead of the game with a good amount of water intake throughout the day.

Urinary tract infections

Urinary tract infections — often called UTIs — are another common cause of strong-smelling urine.

An intense urge to urinate, needing to urinate frequently, and a burning sensation upon urination are the most common additional symptoms of a UTI.

Bacteria in your urine cause urinary tract infections. If your doctor determines you have a UTI, they’ll give you antibiotics to kill the bacteria.

Medications and supplements

Certain vitamins and medications are known to change the smell of urine. Some of these include:

  • vitamin D
  • B vitamins
  • sulfonamide antibiotics
  • certain medications for diabetes
  • certain medications for rhemathoid arthritis

Several common health conditions can cause strong or unusual urine odor. The most common causes include:

Diabetes

A change in urine smell could be a sign of unmanaged diabetes. People with unmanaged diabetes have high blood sugar levels, giving urine an almost sweet odor.

See your doctor as soon as possible if your urine frequently smells sweet. Untreated diabetes is dangerous and can be life threatening.

Bladder fistula

A bladder fistula occurs when you have an injury or defect that allows bacteria from your intestines to enter your bladder. Foul-smelling urine is one of the symptoms, along with severe UTIs.

Bladder fistulas can occur due to surgical injuries or bowel diseases, such as ulcerative colitis or Crohn’s disease.

Liver disease

A sweet urine odor can also be a sign of severe liver disease. Other symptoms of liver disease include:

  • fatigue
  • yellow skin or eyes, called jaundice
  • weight loss
  • bloating
  • loss of sex drive
  • dark colored urine

See your doctor right away if you have symptoms of liver disease. Untreated liver disease can be life threatening.

Phenylketonuria

Phenylketonuria is an incurable genetic condition that is present at birth. Those living with phenylketonuria are unable to break down an amino acid called phenylalanine. When these metabolites accumulate, your urine may develop a “mousy” or musky smell. Other symptoms include:

  • decreased skin pigmentation
  • intellectual disabilities
  • slow-developing social skills

If this disease is not treated early, it can lead to mental conditions such as ADHD.

Maple syrup urine disease

Maple syrup urine disease is a rare and incurable genetic disease that causes urine to smell like maple syrup.

People with the disease can’t break down the amino acids leucine, isoleucine, and valine. Lack of treatment can lead to brain damage and death.

Kidney stones

Kidney stones are tiny, hard deposits that can form in one or both kidneys. They can cause pain for some people, but rarely cause permanent damage if treated quickly.

Symptoms of kidney stones include:

  • sharp pain in your back or side
  • pain while urinating
  • foul-smelling urine
  • a constant need to urinate

One food that many people say makes their urine smell strong is asparagus. The culprit of urine odor from asparagus is caused by the level of naturally occurring sulfurous compounds that the food contains.

This compound is called asparagusic acid. While it doesn’t harm the body, it does create a strong, odd smell after you eat something that contains it — such as asparagus.

Typically, the urine smell will go away after the asparagus has passed through your system. You should contact your doctor to check for other causes if the odor persists.

During pregnancy, it’s possible to notice a change in the smell of urine.

This could be due to a few things, including a change in vitamins, diet, and the fact that many pregnant women may find themselves dealing with UTIs more often. This is often due to the compression of the uterus on the bladder.

The following are some good habits to keep your bladder healthy.

  • Try to pee at least every 3 to 4 hours. If you aren’t going that much, you may need need to drink more.
  • Drink enough fluids during the day, and make sure a good amount of that fluid is water.
  • Try to be as relaxed as you can while peeing. Relaxing your muscles will make it easier to urinate.
  • Don’t rush the process. It’s better to take your time and fully empty your bladder than hold extra urine for too long.
  • Physical activity is helpful for many things, including bladder health.
  • Wear cotton underwear when possible. Other fabrics like nylon can trap moisture and increae the likelihood of bacteria growth.

To determine if your urine odor is caused by a medical condition, your doctor will use several tests. Some of these may include:

  • Urine analysis. A sample of your urine is tested for signs of certain types of bacteria as well as other elements.
  • Cystoscopy. A thin tube with a camera on the end is inserted into your bladder to look for urinary disease.
  • Scans or imaging. Imaging isn’t used often with urine odor. But if the odor persists and there isn’t any sign of infection from the urine analysis, your doctor may choose to take X-rays or do an ultrasound.

Make an appointment with your doctor if you have a strong or abnormal urine odor that lasts for more than 2 days or if you have symptoms such as:

  • sweet-smelling urine
  • mental confusion
  • bloating
  • nausea
  • vomiting

These symptoms may be signs of diabetes, severe dehydration, or liver disease.

Unusual urine odor can be caused by numerous reasons, such as what you ate the night before, the medications you’re taking, and the health conditions you’re living with.

Most of the time, urine odor is not something to worry about. However, if the odor is new and persists, check with your doctor to rule out more serious medical issues.