You’ve just used the bathroom and notice your urine is darker than you expect it to be. It’s a surprising and concerning finding, but what does urine color mean for your health? Tea-colored urine is one sign of warm autoimmune hemolytic anemia (warm AIHA) — but it can also point to other potential health problems.

This article will cover why AIHA causes tea-colored urine. We’ll also discuss other conditions that make urine darker than normal and what other signs and symptoms to look out for.

Why Does AIHA Cause Tea-Colored Urine?

AIHA occurs when immune system proteins called antibodies tag your red blood cells (RBCs) for destruction. The tagged RBCs travel to your spleen, where they are destroyed. Your body can’t make enough new RBCs to compensate for the destroyed ones.

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Dark urine is an important symptom to be aware of if you have warm AIHA. It can also occur in other types of AIHA.

Jaundice Causes Dark-Colored Urine in AIHA

Red blood cells contain an important protein called hemoglobin, which carries oxygen throughout your body. When too many RBCs are broken down, hemoglobin is released and eventually converted into bilirubin.

The liver filters your blood to remove waste products your body doesn’t need. This includes hemoglobin, which breaks down into a chemical called bilirubin.

Your RBCs normally live around 120 days, and then the spleen and liver will filter out the worn-out RBCs. In AIHA, RBCs are broken down too quickly, which releases too much hemoglobin at once. The liver can’t process it fast enough, so bilirubin begins building up in your bloodstream.

Bilirubin has a yellow color to it. This is why people with jaundice develop yellow-colored skin and eyes. Jaundice also makes your urine darker than normal. It may have an orange or brown tinge to it.

Hemoglobinuria Can Be a Sign of Severe AIHA

Hemoglobinuria is the medical term for hemoglobin in the urine. Under normal circumstances, there shouldn’t be any hemoglobin in your urine.

If you do have hemoglobinuria, it means red blood cells are being destroyed within the bloodstream, a process called intravascular hemolysis.

Intravascular hemolysis releases hemoglobin into your bloodstream. When there is more free hemoglobin than the body can handle, some can pass into your urine, making it look red or reddish-brown.

Doctors consider hemoglobinuria a warning sign in AIHA. This means you may have severe disease that needs treatment quickly.

Other Causes of Dark-Colored Urine

AIHA isn’t the only reason your urine may look darker than normal. Certain foods, health conditions, and medications can also affect its color.

Below are some possible causes of dark-colored urine:

Be sure to let your doctor know if your urine changes color unexpectedly. They can run tests and ask about any signs or symptoms you’re experiencing to narrow down a cause.

Is Dark Urine an Emergency?

Dark urine can be a sign of a medical problem, but it isn’t always an emergency. Whether you need urgent care depends on the cause and any other signs or symptoms you have.

In AIHA, dark or red-colored urine may be caused by hemoglobinuria, which can be a warning sign that red blood cells are breaking down quickly. Talk to your doctor about dark or red-colored urine, especially if you have other symptoms of warm AIHA like:

• Pale skin
• Dizziness, feeling lightheaded, or fainting
• Shortness of breath
• Palpitations or a rapid heartbeat
• Yellowing of your skin and eyes (jaundice)
• Pale stools (poop), which is also seen with jaundice
• Swelling of the spleen (splenomegaly)

These all can be signs that your AIHA is becoming severe — especially if they continue getting worse. This can lead to severe anemia or low RBC levels. Without enough RBCs, your body can’t get the oxygen it needs to function.

Tell your doctor about any other abnormal signs and symptoms you’re experiencing with dark urine. This can help ensure you get urgent care if needed.

How Do Doctors Determine the Cause of Dark Urine?

The easiest way to figure out what’s causing dark urine is a urinalysis. A urinalysis uses a urine sample to run various tests.

A dipstick test uses a color-changing stick that detects substances in the urine, such as:

A microscopic analysis tells doctors what’s in urine that can’t be seen by the naked eye. They’ll be looking for:

Bilirubin or hemoglobin in the urine may provide clues that red blood cells are breaking down. On the other hand, RBCs and crystals may mean you have another health problem — like kidney stones.