Jump to content
Acne.org
Search In
Find results that contain...
Find results in...
GuardedlyOptimistic

Ammonia in Urine: Accutane

Recommended Posts

Hi Guys,

Since month 2 I've been experiencing these episodes of discomfort. Obviously, they were not something I really wanted to talk about but since we're completely honest, let's be completely honest. There seems to be a very strong smell of ammonia in the urine. Anyway, and sorry for the gross post, I told my Derm in Month 3. She said that she "could" send me for a test but that because Kidney problems were not typical on Accutane there was really no need. Then she ushered me out of the office and that was it. So, the same happened in month 3 and 4. Finally I decided to do some research.

This is what I found:

There are some medical conditions (mostly liver disorders) that can

increase the level of ammonia in the blood, and this can also lead to

increaesed concentrations of ammonia in the urine.

However, that does not mean that a strong ammonia odor in urine indicates

a liver problem! A conversation with the learned physician Dr. Elias

Karkalas revealed to me that a diet of red meat, or other high-protein

food, can cause an increase in the excretion of nitrogen compounds,

both ammonia and urea (which itself has an ammmonia-like smell)."

Ok, except, I'm a vegetarian. I probably don't get enough protein. So now i'm worried. Now, let's be real: I'm a bit of a hypochondriac. I know that i've been worried along the way, but for my Derm to say nothing about this. For her to say that it has nothing to do with Tane is so worrisome. I found that there is a connection by doing a google search. He went to 10 plus years of university and didn't see the connection. So disheartening.

Anyway, I made a doctor's appointment for tomorrow. I have to find out what my GP says. I'm not taking my tane for today and because I haven't been feeling all that well these past 2 days, I self-reduced my dose to 40 mg from 60. I know that I wanted to do a fifth month but if i'm not feeling well, this might be the end of the road for my accutane ride.

Now, i've been really bad. I haven't been drinking much water at all. Big mistake. Big regret. What astonishes me is the contradictions I've heard from pharmacists and doctors alike. Some pharmacists I talked to said that I should take lots of water to circulate the drug in my system. The derm told me that changing the amount of water I drink makes no difference at all. Who do I believe?

Guys, I'm scared. I need some support.

Share this post


Link to post
Share on other sites

Also, my cholesterol went up 100%, and my triglycerides are way up. I didn't ask the numbers because being a hypochondriac I didn't think it would make me feel any better. The truth is i've put all my faith in my Derm.

Share this post


Link to post
Share on other sites

I noticed this smell this morning, GO! I didn't know it was ammonia. Also, I didn't really have anything to eat or drink after my dental surgery yesterday. Hmm.

Share this post


Link to post
Share on other sites
Guest Craigems
However, that does not mean that a strong ammonia odor in urine indicates

a liver problem! A conversation with the learned physician Dr. Elias

Karkalas revealed to me that a diet of red meat, or other high-protein

food, can cause an increase in the excretion of nitrogen compounds,

both ammonia and urea (which itself has an ammmonia-like smell)."

Share this post


Link to post
Share on other sites

It still might be a good idea to have this checked out though. I was also thinking "what the fuck". It was such an awful smell.

Share this post


Link to post
Share on other sites

Yup, me too. My whole digestive tract is kinda whack right now I think. But I think that water intake has a LOT to do with it. This sounds lame, but I remember learning in high school biology that the more water you drink, the lighter and cleaner your urine will be (makes perfect sense). I always think of this when my urine is dark and smells strong. I know for a fact I don't drink enough water (1-2 glasses a day - and that's if I remember).

I'm so the opposite of you guys, I'm like the anti-hypochrondriac, haha. I never think about side-effects other than my lips and eczema - the physical manifestations. I can't imagine the anxiety you are going through, it must feel horrible sad.gif So I really hope you can pull through it and lift the weight off your chest.

As a side note, it always interests me how often you guys get blood-tests in the States (or maybe it's just my derm, who knows). I had one blood test at the 6 week mark, and that was probably the only one I'll have! I don't even know what all the numbers mean, and my derm didn't tell me the numbers anyways. I wonder if all the hype your derms put you through heightens the paranoia that it seems a lot of you have on this board. It seems that your derms really stress all this "careful monitoring", blood tests, pregnancy tests, numbers, levels. But anyways, I do hope you can relax a bit because I'm sure you're going to be just fine smile.gif

Mae

Share this post


Link to post
Share on other sites

I had a blood test before I started and I'm having another next week, I think (about 6 weeks). This may be my last blood test as well. I don't know. I was never given the results from the first blood test either. Maybe they assume people don't care.

Oh, and I didn't have to sign the consent forms. My derm forgot about them eusa_shifty.gif

Share this post


Link to post
Share on other sites

What is ammonia smell? How do I find out ammonia smell? Is there some common houselhold substance that has that smell so I can use it as a baseline.

Share this post


Link to post
Share on other sites

Ok, first of all, we should all demand urine tests. This is not ok and could be a sign of kidney and liver damage. Taners, uprise. This is not ok.

I have an appointment for tomorrow where I will talk to my doc about this.

Also, I had to get blood work done every 3 weeks while on Tane.

I have a few questions for your guys. Do you guys get this odor consistently or occasionally? now and then? Do you find it when your urine is dark? Thirdly, do you get any slight lower back pain? Please guys, it's important that we be very specific about the symptoms so that we can understand what's going on inside of us.

It's hard to decribe smells. But, ammonia smells like hair dye. That's how I would decribe it. Like bleach.

Share this post


Link to post
Share on other sites

Craig, I never said it was safe!!! You should definitely get checked out. And, your body may be going through ketosis which could be damaging your kidneys.

God your a life-saver, i smelt this also... i was like what the fuck... But i just remembered i'm on Protein shakes! as well as Accutane! VERY VERY stong Amonia smell!

But i'm glad its safe smile.gif thanks for clearing that problem up GO ... i was actually gonna make a post on that. eusa_dance.gif

Share this post


Link to post
Share on other sites

I went for urine/blood tests last week because I was having frequent urination and the color was dark (not brown like blood which is normally the sign of UTI, but a dark yellow.) I haven't gotten my results yet. I forgot to call my derm today. I wouldn't notice back pain since I have that all the time (thanks to the 4 car accidents I've been in). I've been taking Craigems advice and downing the water, so I don't know what caused it.

You have to ask for a urine test if you want to check this symptom out. They only request certain types of tests to be done, so if your derm doesn't order it, you're not going to get it.

This is where I've been doing my reading:

http://www.fda.gov/cder/drug/infopage/accu...cationguide.htm

-snip-

Abdomen (stomach area) problems. Certain symptoms may mean that your internal organs are being damaged. These organs include the liver, pancreas, bowel (intestines), and esophagus (connection between mouth and stomach). If your organs are damaged, they may not get better even after you stop taking Accutane. Stop taking Accutane and call your prescriber if you get severe stomach, chest or bowel pain, trouble swallowing or painful swallowing, new or worsening heartburn, diarrhea, rectal bleeding, yellowing of your skin or eyes, or dark urine.

Signs of other possibly serious problems. Accutane may cause other problems. Tell your prescriber if you have trouble breathing (shortness of breath), are fainting, are very thirsty or urinate a lot, feel weak, have leg swelling, convulsions, slurred speech, problems moving, or any other serious or unusual problems. Frequent urination and thirst can be signs of blood sugar problems.

Share this post


Link to post
Share on other sites

i'm not sure, but the dark urine refered to on the FDA website is related to jaundice (which is why it is included in the list with yellowing of the eyes, etc)...jaundice can occur from any assault on the liver.

i would definitely suggest getting a urine test. and i would also suggest drinking a lot of water. if when you are completely hydrated your urine is STILL dark and smelly, then that is a problem...

but better safe then sorry, get all the tests...good luck at the MD tomorrow.

peace.

Share this post


Link to post
Share on other sites

Guys, I'm scared. I'll be honest. I'm going to go to the dr tomorrow. If my derm kept prescribing me tane whilst knowing things weren't right, i'll be really angry. My only comfort is that the urine doesn't have that ammonia characteristic all of the time and i'm not thirsty all of the time.

Pray for me guys, please. I really wanted to do my 5th month but...at what cost?

Share this post


Link to post
Share on other sites
Guest Craigems

GO, its okay... I really only get it after i take high amounts of protein ... and in the mornings when i really need to go ... BUt i drink tonns of water so my urine is never really dark ... only occasionally it is and when its like that thats when i smell it!

When its white/clear urine, it doesnt smell. GO try this ... Drink as much water as you can in a day try and average 12 glasses a day... You will go to the toilet heaps but ... let me know if you can still smell it with every one because Personally its only when mine is a tad darker. (As i said i am taking higher than normal doses of protein which is safe btw, so i can blame mine on that coz i know when i dont take it i def. dont smell amonia).

ITS REALLY IMPORTANT TO DRINK WATER THROUGHOUT THE DAY ON TANE!!!!

Share this post


Link to post
Share on other sites
Guest Craigems

Also GO can you let us know the results about your doctors visit on this issue... i like many of us will be really keen to know the opinion on this matter. But also dont forget to tell the doc that you dont drink that much water. .. maybe thats your problem :/

Share this post


Link to post
Share on other sites

GO, I’m worried for you. Please let me know what the doctor says.

I haven’t noticed an odd smell to my urine since I’ve started Accutane. I do drink excessive amounts of water, however so that might play a factor. My urine is darker than usual but I’ve always thought this was a sign of dehydration so I just drink more water.

(My lower back hurts right now because I took a dive down the stairs last Thursday but I don’t think that’s what you’re talking about.)

Now I'm freaking out! Great!

Share this post


Link to post
Share on other sites

GO, you're in my type of prayers, thats for sure. Im so glad you're looking out for yourself, I know how bad you want this 'tane to work - but you're right- at WHAT cost? You're so much like me, i'd be having a heartattack by now. So YAY for you for being strong. It's okay to be scared girly, im just glad you're not running from it. Keep us posted, and like I said, you're in my prayers.

I too have some of those symptoms on that list, and it makes me nervous because anything I bring up to the derm - seems trivial to him - and that leaves me both helpless and hopeless. Im interested to see how this pans out for you for your own sake as well as all of us w/ignorant derms. You're right, we need to rise up to this and protect ourselves. It's certainly not OUR faults that 'tane gets such a bad rep - its those ignorant Derms who don't take our side effects seriously because they're supposedly 'rare'. Thanks for being so well-informed. smile.gif

~Jess

Share this post


Link to post
Share on other sites

GO: I’ve been thinking about this situation all morning and wondering what us ‘taners should do in order to ensure that our internal organs are okay. It’s difficult to think about what is going on inside our bodies when we are so preoccupied with our skin. The reality is that Accutane effects more than just your skin. Our higher triglycerides are a testament to that fact.

I already had a phone call into my dermatologist to discuss options for my overly dry skin (shaving my legs is now uncomfortable). When he calls back, I am going to ask him to fax over a prescription for a urine test that will hopefully show how my kidneys, liver, etc., are all doing. I urge anyone else experiencing the dark urine situation to do the same. Even though I don’t have lower back pain and my only side effect is the color of my pee, I am not taking any chances here. It concerns me more that I am only having blood drawn and no urine tests at all, especially since (from what I’ve gathered) certain problems can only be detected through your urine. Why aren’t doctors doing both? Is it a medical insurance thing? Why would an insurance company rather pay for my liver failure than for my piss-tests?

I am going to suggest to my doctor that he has his Accutane patients have both blood and urine tests monthly.

By the way, my triglycerides have gotten significantly better since my last blood test in early January. They went down almost 100 points. For a while I was unsure how this happened but my diet has improved a little bit so I’m sure that plays a factor. I am trying to eat more vegetables throughout the day and am having Raisin Bran for breakfast more often. For lunch, I opt for a salad with fatty ranch dressing and chicken (sorry, I know you’re a Vegetarian, GO). This is much better than a McDonald’s Sandwich or a Boston Market Carver. I drink a lot of water to help with the digestion and processing of the food as well. I haven’t tried it yet I’ve heard that garlic can lower cholesterol.

Good luck to everyone and let’s keep each other posted regarding this.

Share this post


Link to post
Share on other sites

I'm praying that everything's okay, GO.

And I'm hoping it's just my "pill diet" for me. Seriously, that's all I've been eating these last few days.

Share this post


Link to post
Share on other sites

I hope nobody will mind my 2 cents on this issue, and coming from the self-proclaimed "anti-hypochondriac" wink.gif I don't mean to offend anyone at all in the slightest, but I agree with Craig, I really think it's just that we're not drinking enough water. But if you're scared and you feel something's wrong, get the test done if it'll make you feel better. I guess I'm just not really understanding why there's is such a huge concern eusa_think.gif Seems like a bit of an overreaction to me? I've had dark/strong smelling urine many times in my life, due to whatever reason, so I believe in my case it's really just that I'm not flushing my body out properly, regardless of whether I'm on Tane or not. I hate the taste of water so I really have to convince myself to drink it shock.gifwink.gif

Anyways, I don't mean to undermine your concerns, I just think sometimes we let our paranoia get the best of us, and that isn't healthy either! But as someone said before, you know your body best of course... keep us updated on your test results. I truly hope there is nothing actually wrong!

Mae

Share this post


Link to post
Share on other sites

Thanks guys. I don't know what I'd do without you. I never want to find out smile.gif

I'm going to the Derm in an hour and will discuss this with her. She'll give me a pee test in the office. Well, I won't pee in her office (though I know I threatened that in the past: haha). All she has to do is put a PH strip in the yellow juice. I hope everything is ok. Either way, the past two days that i've been off tane, i've felt pretty good. Though, I got a new lesion !! Small, but still. Gosh.

For any of you guys that need a little pick me up, I think you should rent Napoleon Dynamite. You just might pee your pants.

Share this post


Link to post
Share on other sites

Mae, Thank you for your concern smile.gif

I hope nobody will mind my 2 cents on this issue, and coming from the self-proclaimed "anti-hypochondriac" wink.gif I don't mean to offend anyone at all in the slightest, but I agree with Craig, I really think it's just that we're not drinking enough water. But if you're scared and you feel something's wrong, get the test done if it'll make you feel better. I guess I'm just not really understanding why there's is such a huge concern eusa_think.gif Seems like a bit of an overreaction to me? I've had dark/strong smelling urine many times in my life, due to whatever reason, so I believe in my case it's really just that I'm not flushing my body out properly, regardless of whether I'm on Tane or not. I hate the taste of water so I really have to convince myself to drink it shock.gifwink.gif

Anyways, I don't mean to undermine your concerns, I just think sometimes we let our paranoia get the best of us, and that isn't healthy either! But as someone said before, you know your body best of course... keep us updated on your test results. I truly hope there is nothing actually wrong!

Mae

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Personalized Advice Quiz - All of Acne.org in just a few minutes

×