Story at-a-glance -

• Groups have been drinking urine for millennia; while there are some case studies demonstrating little harm, it is likely that consuming excreted waste products will stress the kidneys and not provide much benefit
• Urban legend holds urine is sterile in a healthy person, but using sensitive testing equipment researchers have discovered bacteria in urine, even in the absence of signs of infection, suggesting the bacteria may function in much the same way as it does in the gut, in terms of having beneficial and harmful effects
• Topical use of urine has been successfully used to treat eczema, psoriasis and atopic dermatitis; however, it is the urea compound in the urine that is effective and not the entire chemical makeup of urine
• There are likely far more chemicals in your urine than you bargained for, including toxins, pharmaceuticals and cosmetic chemicals, making consumption more dangerous than it may have been 100 years ago

The human body is a complex system with a unique elimination structure to get rid of waste products and balance water levels. The urinary system is one part that may provide clues about your overall health status. The system is made up of organs, muscles and nerves working together to create, store and excrete urine.1

You have two kidneys where the urine is created and two ureters transporting the urine into your bladder. The ureters enter at the top of the bladder on either side. At the bottom is a sphincter muscle leading into the urethra, which in turn carries urine out of your body.2

After your body has metabolized food, waste products are left behind. Along with your lungs, skin and intestines, your urinary system balances these chemicals and water. A normal healthy adult will eliminate about 1.5 quarts of urine every day, depending on the amount of food and fluid you consume, how much is lost through sweating and breathing, and any medications you might be taking.3

Urea is one of the waste products produced when foods containing protein are metabolized.4 Although the function of urine is to excrete metabolic waste products, there have been those who believe urine holds medicinal properties.

The ancient practice of the golden fountain

The practice of drinking urine or applying it to the skin has been used worldwide for millennia. Shivambu — the practice of drinking urine — is a Hindu practice over 5,000 years old, and is believed to have rejuvenating properties.5 Culturally, the medicinal act of drinking urine was practiced in Egypt, China, Thailand and during the Aztec empire. Pliny the Elder used urine topically for treating sores, burns and scorpion stings.

In the 2010 paper, "The Golden Fountain — Is urine the miracle drug no one told you about?," Jutta M. Loeffler, a researcher from the University of London, writes:6

"The almost 100,000 hits of the search for 'urine therapy' on Google … are an indicator that drinking 'waters out of thine own cistern' is still, or again, rather popular today … There is, it seems, virtually nothing urine won't cure. Modern proponents use pseudoscience to explain the benefits of the various, mostly exaggerated, components of urine …

This said, the situation described in the paper7 by Ogunshe, Fawole and Ajayi in this journal, is quite different. Here, the use of human or cows' urine does not stem from an esoteric search for eternal youth or someone's personal rage against the establishment, but from bare necessity in an economically struggling part of the world where modern medicine or the money to pay for it, is lacking."

Loeffler goes on to discuss the research8 of Ogunshe et.al., and how urine therapy may have gained popularity in some African areas "because of increasing poverty."

In particular, the Ogunshe paper looked at the safety of administering urine to children suffering with febrile convulsions. It turns out to be a bad idea, for the most part, as testing of the urine revealed the presence of antibiotic-resistant bacteria.

"In the absence of proper clinical trials it is difficult to prove that traditional urine therapy contributes to childhood mortality in Nigeria, but given the results of the present study, the treatment of vulnerable and already ill children with urine should be strongly discouraged," Loeffler writes.

Modern-day Shivambu practice

Despite such concerns, members of the Boulder, Colorado, Urine Therapy Meetup Group believe consuming urine or using it topically has health benefits. The members meet monthly at the public library. New members are introduced to the daily practice of auto-urine therapy called Shivambu.

Some group members have spoken with the media and described drinking their urine or applying it topically for years, and claim it has cleared eczema. Others have described how they use it but not any of the benefits they ascribe to it. Dr. Andrew Thornber,9 chief medical officer at the Now Healthcare Group, told BBC Three:10

"The whole point of urinating is for the kidneys to filter the blood and it gets rid of any excess fluid and salts, as well as minerals. Urine in a healthy person is made up of about 95% water, but the other 5% is waste products the body is looking to expel — such as potassium and nitrogen — which, if you have too much in your body, can cause problems."

Is urine normally sterile?

According to information presented by Evann E. Hilt,11 a researcher from the department of microbiology and immunology at Loyola University, at the 2014 American Society for Microbiology conference,12 bacteria are normally present in low levels in the urine of healthy individuals.

This contradicts claims that urine is sterile. Hilt asserts this belief has its roots in the 1950s, when epidemiologist Dr. Edward Kass13 developed a method to screen for urinary tract infections before surgery.

Kass found using a midstream urine test, in combination with a numerical cutoff for the number of bacteria found to less than 100,000 colony forming units per millimeter of urine, could determine if an individual had a urinary tract infection.14,15

The test was considered negative when bacteria grown in the lab failed to meet this threshold. Hilt believes this is where the urban legend developed16 — the idea that urine from a normal healthy person is sterile — as patients were often informed their urine was negative for infection and without bacterial growth.

The midstream, clean catch urine collection method was designed to reduce the amount of bacterial contamination as bacteria passes through the urethra and out of the body. Hilt used a more sensitive technique to detect low levels of bacterium, and evaluated the bacteria found in the bladders of 84 women collected by straight catheterization.

Half these women had overactive bladder syndrome, causing them to urinate frequently.17 The team found 71.4% of the samples contained bacteria; the women with overactive bladder also had a greater diversity of bacteria than controls. According to the presentation abstract, "a total of 217 bacterial isolates from 77 different genera were isolated from OAB patients, while 66 bacterial isolates from 33 different genera were isolated from control patients."

The researchers hope this may help provide treatment for the 15% of women who suffer from overactive bladder as many do not find relief from therapy addressing the condition as a muscular disorder.18

There are more areas in your body that aren't sterile

Hilt's work19 demonstrates urine is not sterile and changes the way you might think about infection. Her results suggest there's a normal community of bacteria living in the bladder that may function in much the same way bacteria do in the gut, in terms of having beneficial and harmful mixes of bacteria in the same area.20

Scientists have long thought other areas of the body were also sterile and only the intestinal tract running from the mouth to the anus contained bacteria. However, a study published in 201421 found the placenta is also home to a community of bacteria similar to those found in the mouth.

The microbes are nonpathogenic, but variations and composition may trigger preterm birth, occurring in 9.93% of U.S. pregnancies.22 This study was triggered by another published in 2012,23 in which the researcher found the most abundant microbes in a pregnant woman's vagina were different than those found in nonpregnant women.

However, the microbes were not commonly found in the stool of the infant during the first week of life. In other words, during a vaginal delivery, the infant did not pick up the bacteria from their mom's vagina. Dr. Kjersti Aagaard, obstetrician at Baylor College of Medicine in Houston and lead author of the studies24,25 commented:26

"If we start thinking of the placenta as a conduit or facilitator of maternal-fetal communication and not as a barrier, then I think we open ourselves up to very interesting perspectives on how we've interpreted a lot of developmental biology today."

In the absence of disease, the brain is also assumed to be a sterile organ. However, a study published in 201327 reported finding alpha-proteobacteria, normally found in the soil, in people's brains.

The researchers were evaluating whether those with HIV/AIDS might be prone to brain infections and instead found all the brains they evaluated contained bacteria, whether they had HIV or not. This discovery illuminates how much further science has yet to travel before we will know what is considered "normal."

Cosmetic industry uses topical urea

Your skin is a barrier protecting your body from the elements. It helps regulate temperature and is important in balancing hydration levels. Alterations in function are associated with different skin diseases, including atopic dermatitis, psoriasis and eczema.28

Urea is a component found in urine and used in natural moisturizing factors of the skin. It plays a role in preserving hydration and integrity. In some cases, urea is also added to cosmetic products to treat nail problems, such as ingrown toenails. It has a keratolytic property, helping to remove dead tissue and promote wound healing.29

It increases moisture in the skin by softening the keratin holding the top layer of skin cells together and thus acts as an exfoliant.30 Urea creams may be prescribed or purchased over-the-counter. When added to a product, it changes the acid-base balance and slows the loss of moisture in the product.31

According to the Environmental Working Group (EWG) Skin Deep Cosmetic Database,32 urea received a score of "3," placing it at the lowest level of a moderately hazardous cosmetic. EWG notes the use is restricted in Canadian cosmetics.33

Side effects of using urea-based creams include burning, itching, redness or irritation to the area. If you experience the side effects or they become more serious, including blistering or peeling, report them to your physician as soon as possible.34

There may be more than you bargained for in your urine

An estimated 70% of all pharmaceutical drugs you consume are excreted in urine, including over-the-counter drugs.35 Other environmental toxins are also metabolized and excreted through your kidneys, such as tobacco smoke, pollution and some components of food. In fact, you may find evidence of exposure to these toxins by evaluating what's found in your urine.

One emerging field in environmental health is DNA adductomics, or the study of a segment of DNA bound to a cancer-causing chemical. One method of measurement is using urine samples to extract the information and better understand environmental stressors on the body.36 In other words, drinking urine exposes you a second time to segments of DNA attached to cancer-causing chemicals your body is excreting.

One study37 that spent seven years analyzing the chemical composition of human urine found at least 3,079 compounds. According to Live Science, 72 were made by bacteria and another 2,282 were metabolites from diet, drugs, cosmetics or environmental exposure.38

Co-author David Wishart, Ph.D., professor of biology and computing science at the University of Alberta, commented,39 "Urine is an incredibly complex biofluid. We had no idea there could be so many different compounds going into our toilets." The compounds found in urine fell into 230 different chemical classes. However, the researchers wrote:40

"Given that there are only 356 chemical classes in the entire human metabolome, this certainly demonstrates the enormous chemical diversity found in urine. The fact that so many compounds seem to be unique to urine likely has to do with the fact that the kidneys do an extraordinary job of concentrating certain metabolites from the blood."

Glyphosate found in 93% of urine sampled

One dangerous chemical known to have increased in urine samples is glyphosate.41 Researchers from the University of California San Diego School of Medicine found human exposure increased approximately 500% since the introduction of genetically modified crops to the food supply.42

In another study commissioned by the Organic Consumers Association,43 a public testing project was carried out by the University of California San Francisco and glyphosate was discovered in 93% of urine samples collected in 2015.44

This was a unique project as it was supported by members of the public who paid for the urine and water samples to be analyzed. The early results were from the first 131 urine samples tested.45 Ronnie Cummins, international director of Organic Consumers Association, commented:46

"If consumers had any doubt about the extent to which they are being poisoned by Monsanto's Roundup, these tests results should put those doubts to rest. These test results highlight the massive failure of U.S. regulatory agencies, including the EPA, USDA and FDA, to protect us even as they continue to perpetuate the myth that low-level exposure to glyphosate is harmless."

Another study, published the year before found:47

"Glyphosate was significantly higher in humans [fed] conventional [food] compared with predominantly organic [fed] humans. Also the glyphosate residues in urine were grouped according to the human health status. Chronically ill humans had significantly higher glyphosate residues in urine than healthy humans."

Drinking urine contaminated with glyphosate only increases your cellular exposure to a chemical the World Health Organization has deemed a probable human carcinogen.48,49,50 Unless you exclusively eat organic, non-GMO foods or grow and raise your own food, you likely have glyphosate excreted in your urine.

Stay hydrated to keep your urinary system healthy

Aside from consuming waste products that your body is trying to get rid of, drinking urine may also lead to dehydration. Even low levels of dehydration may lead to headaches, lethargy and constipation.51 Your body has a sophisticated management system that depends on drinking fluids and eating foods to replace the water lost from breathing, sweating, urinating and defecating.

Drinking pure water every day is a key component to optimal health, but many have made the mistake of forgoing water for other types of fluid. Sweet drinks, fruit juices, soda and sports drinks may have taken the place of pure water in your fluid replacement.

In one Harvard study,52 researchers found more than half of American children are chronically dehydrated, which may have repercussions on health and academic performance. Since 73% of your brain is water,53 when you're dehydrated your brain shrinks in volume. This may alter brain function and impact your mood.54

Your body's fluid needs may vary throughout the day, and from one day to the next, so an important guideline to maintaining good hydration is to keep an eye on the color of your urine. Concentrated, dark colored urine is a sign your kidneys are trying to retain fluid to maintain your bodily functions, and a good indication you need to drink more water.

Ideally, you'll want your urine to be a light straw-colored yellow. It's important to listen to your body, watching your thirst level and the color of your urine. If you feel fatigued or moody, it may also indicate you need to drink more water. On average, a healthy number of bathroom visits is seven or eight per day.