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Like most people who grew up after April 22, 1970, I think it is important to be as environmentally responsible as possible.  Like many I fail miserably much of the time, but at least I feel guilty about it.  Recycling offers the opportunity to feel good about my environmental impact with little effort, since the garbage collection infrastructure in Portland makes recycling easy.

Some products are best extensively reprocessed before reused. Urine, as an example. There are proponents of topical and/or drinking urine as a treatment/cure for nearly any illnesses.  The kidneys are mostly responsible for fluid and electrolyte balance and I realize that normal urine is mostly water, salts, urea and a smattering of other very dilute molecules. I have the urine tox screen to prove it.  Urine is not a particularly noxious body fluid, but it is not high on my list of liquids to drink under normal circumstances.

Urine is mostly water but not an optimal source of water if it is your only source for fluids.  Urine drinkers love to mention the occasional trapped earthquake victim who survives, in part, from drinking their own urine.  For the first several days the urine would be dilute enough to keep people reasonably hydrated, as humans cannot concentrate urine as well as, say, a camel.  So I can see where consuming urine for a short period of time would delay progressive dehydration and death. A couple days of drinking urine neat, shaken not stirred, would be harmless and, if there were no alternative sources of water, beneficial. I do suffer from the societal taboo that piss is icky, and for aesthetic reasons urine is not something I would want to consume, even when it is referred to as its more common designation ‘Coors Light’.The kidney, I should mention, is the only organ in the body that functions on magic.  Really.  Does anyone actually believe/understand the function of the so called Loop of Henle?  I scoff at those who talk about human energy fields or water having memory, but as best I can tell, the Loop of Henle is no different.  My undergrad degree was in physics, so at some point I suppose I ‘understood’ quantum mechanics and relativity, at least well enough for the tests. The Loop? Bah. Total smoke and mirrors.

Drinking your own piss has a long history, especially in India and Asia and advocates (mis)quote the bible:

Proverbs 5:15. Drink water from your own cistern, running water from your own well.

Although the following verses suggest that it is a metaphor for marital fidelity, not consuming pee.  The bible has never been a convincing source of medical advice, although with teenage boys at home, I increasingly see the wisdom of Deuteronomy 21:18-21, Exodus 21:17 and Proverbs 30:17.

The rationale behind drinking your urine is simple: it is an ultrafiltrate of all that is best in the blood, with none of the toxins, which are processed and disposed of by the liver.  So when you drink your urine, you are consuming a golden elixir of salts, proteins, and hormones, containing all you need to treat virtually every disease and maintain health.  Sort of an uber-energy drink with none of the caffeine and fewer calories.  Your own, early morning, midstream urine is to be preferred, and in a pinch you could drink others urine, preferably from the same sex.  I suppose it would be wise to avoid the urine of  the autistic, it being loaded with mercury, aluminum, and perhaps other toxic metals.

Are there uses for urine? Popular culture has it that peeing on a jellyfish sting will relieve the pain; this is neither supported or denied by the Pubmeds.  It appears to be the one therapy with no supporting Cochrane review.  Urine on a jellyfish sting, if dilute, is counterproductive, since fresh water will trigger jellyfish nematocysts to fire and increase the pain of the sting.

Similarly, topical urine is advised for bee, mosquito and other venomous bites, with neither supporting or disconfirming data.  Given the medical benefits of urea (mostly as a moisturizer at concentrations many fold higher than in the urine) and other molecules in urine, they may be products in piss that would inactivate venomous stings.  I can’t dismiss the concept out of hand, although concentrations in  the urine of well hydrated people would be minimal. So use the urine from a trapped earthquake victim or lifeboat survivor,  which will become concentrated with time, and not your Corona addled swimming or hiking partner.

It is an ongoing curiosity how proponents of curious therapies will take a bit of truth an magnify its significance out of all proportion to reality. An example.

Urokinase is a protein that has utility in dissolving clots.   Its dose, depending on what is treated, is around 500,000 to 2 million units IV.  Normal urine contains urokinase, but how much?  ” Normal human urine contained 2068 ± 0.36 u/ml of UK”    Hardly enough to have any effects should it be consumed orally, especially given the ability to the gi tract to reduce any protein to amino acids.  Yet because urokinase is useful in high doses iv in patients with clot, it is also useful orally as a medicine. Odd logic.

One site notes there are 2 grams of protein and a 100 mg of glucose excreted the urine a day.  Is that lot?  A dollar bill weighs a gram and we make 1 to 2 liters of urine a day.  So a cup of urine will contain about half a dollar bill in weight of protein (roughly the same as a McDonalds meat patty) and 25 milligrams of glucose,  about as much as the “one” on the back of a dollar. Compare that to 8,000 milligrams of protein and 12,000 milligrams of glucose in a cup of milk. Not quite homeopathic concentrations, but close.

The arguments behind the use of medicinal piss are the usual: appeals to antiquity (not mentioning the average life expectancy of the ancients was just a tich longer than a fruit flies), innumerable anecdotes, and the ever popular secrets “they” don’t want you to know.

The medical community has already been aware of [urine’s] astounding efficacy for decades, and yet none of us has ever been told about it. Why? Maybe they think it’s too controversial. Or maybe, more accurately, there wasn’t any monetary reward for telling people what scientists know about one of the most extraordinary natural healing elements in the world.”

It is getting increasingly difficult to keep track of all the miracle cures I am supposed to keep secret.  One of these days I am going to slip up and inadvertently cure someone with an effective and inexpensive natural remedy. Even dogs and monkeys participate in the healing effects of drinking their own urine.  Or they have sloppy aim.  Of course monkeys and dogs eat their own vomit, so I doubt they have a discerning palate.

My Loop of Henle psychosis not withstanding, the understanding of renal physiology by urinologists is, well, interesting.  One site calls urine “purer than distilled water” and then lists all the beneficial chemicals in the urine. Given that the purpose of distilled water is to make the product nothing but H20, it is an interesting contradiction.

or

Urine is believed to be a byproduct of blood filtration. It is NOT excess water that is released by the body. When blood filled with nutrients pass through the liver, the toxins are filtered out and are excreted as solid waste. The purified blood then travels to the kidney where excess nutrients are eliminated from the body.

George Carlin used to talk about ‘jumbo shrimp’ and ‘military intelligence’; perhaps we should add ‘CAM understanding’ to the list.

The problem is getting the nerve to drink your piss since there is an aversion to consuming pee. As Rita Mae Brown said in a different context, “Nothing is unnatural – just untried.” If you work yourself up to it, all things are possible:

How many people do you know who have drunk enough urine to really know what it tastes like? Probably not too many. Those who regularly drink their own urine say it. But taking urine into your mouth might be too big a step to begin with. Rubbing a drop into the and first smelling your own urine can help you to overcome part of the barrier. Really, it often does not smell bad at all. Many people even like its sometimes sweet odor. More extensive massaging of urine into your skin is also a good way to become accustomed to your life water. How can you overcome feelings of aversion to drinking your own golden elixir? Start by drinking a drop then a sip each day and slowly build up to a fill glass of urine. This is the most comfortable way to allow your body, mind and soul to become accustomed to this therapy.

I’ll pass.

It would seem for those who participate in urine therapy there is a certain embarrassment in talking about their life changing cure for everything.  It is kind of sad, really, and I feel for them.  It must be difficult to have easy access to the cure for all diseases and have to feel uncomfortable about discussing it due to societal taboos.  And if we meet in public, really, I don’t want to know if you drink piss. That would be, under almost every circumstance, the OED definition of over-sharing.

Urine therapy is, of course, a panacea.

…one of the most powerful, most researched and most medically proven natural cures ever discovered. Multiple sclerosis, colitis, lupus, rheumatoid arthritis, cancer, hepatitis, hyperactivity, pancreatic insufficiency, psoriasis, eczema, diabetes, herpes, mononucleosis, adrenal failure, allergies and so many other ailments have been relieved through use of this therapy

Not a bad list.  Looking on the interwebs, there is no medical condition that is not amenable to treatment with either topical or oral urine, and they wisely advise against intravenous injection.

Any evidence for efficacy?  Nope.  Just testimonials.
Any reason to suspect drinking your piss would help any medical condition?  No.  Given the dilute nature of the products in urine, it should be neither helpful nor harmful.

Of course, the lack of efficacy or plausibility is no hindrance to use.  As one web site on the mechanism of urine therapy notes

…theories have never been proven using modern scientific procedures to verify his ideas, and at some levels has been completely dis-proven, but nevertheless people still believe them. Maybe the power of belief in this instance overcomes what factually may not be real.

Sums up the whole field of alt med, does it not?

Addendum

The links to sources in this entry may or may not refer back to original sources.  As is often the case in the more marginal CAM therapies, many sites appear nearly identical in content, one large cut and paste fest. Even Vanderbilt University regurgitates the same text as if were original without proper references; one would think a University would be sensitive to issues of plagiarism,  although perhaps Vanderbilt is the original source.

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  • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at edgydoc.com.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at edgydoc.com.