Urine Therapy: Is it Safe and Does it Work?

After a Yoga class in India, I was surprised when a fellow student asked me if it’s okay to drink urine. I had just joined a month-long course and had apparently missed a lecture a few days earlier on the health promoting effects of pee drinking.

Off the cuff, I told her I didn’t think drinking a little bit of her urine every morning would harm her, but I didn’t understand why she would want to do such a seemingly crazy thing either.

yoga hall

That month, my Yoga teacher would smile big most mornings and ask if I had tried my own natural health promoter yet. He even sweetly offered to come to my place to coach me through it, saying that the first taste is the hardest. He said you need to get through the psychological aversion that comes from being told in the West that urine is a waste product when in fact it is full of vitamins, proteins, and hormones that nourish the body and fight disease.

Teachers and students weren’t just drinking it. Ulrika, from Iceland, had a face pock-marked from years of acne. Only scars were left with no active disease, and this she attributed to her recent time spent at a urine therapy hospital not far away. Caretakers had rubbed her own urine into her face and massaged her body with cow urine.

Students directed their yellow streams onto the fungus of athletes feet, soaked it onto bandages placed over pus-filled wounds, and even douched urine to alleviate vaginal yeast infections.

When I was first asked about urine therapy in India, I hadn’t thought about it much. In fact, I hadn’t thought about it all. I hadn’t realized that there’s a whole tribe of people out there who see it as natural medicine. Since then I’ve taken a much closer look, reviewing the basic science and whatever studies I could find in an attempt to get to the truth.

So, what is the truth about urine therapy? Can it help you? Can it harm you? And is this really a part of Yoga?

In this article, we’ll take a brief look at the Yogic literature promoting urine therapy. We’ll review what urine is composed of and how and why it’s formed by the body. Then the potentially beneficial and the potentially harmful effects of different components of urine will be explored.

Urine Therapy in the Yogic Literature

The oldest text from the Indian subcontinent encouraging the use of urine in healing is the Damara Tantra. It gives a detailed description of how to use urine, sometimes mixing it with specific herbs or minerals to cure disease.

The Damara Tantra, specifically the part known as Shivambu Kalpa, suggests collecting urine in a copper bowl, eating light and unsalted meals, getting plenty of rest, and sleeping on the ground. Then one should wake up before dawn and, leaving the first and last portion, should collect the middle part of the morning’s first flow. According to the author, after one month it brings about purification and after twelve years it bestows the power “to live as long as the moon and the stars.”1,2

Damara Tantra, Shivambu Kalpa:

Sloka 9 – “Shivambu (one’s own urine) is a divine nectar! It is capable of abolishing old age and various types of diseases and ailments. The follower should first ingest his urine and then start his meditation.”

Slokas 30 and 31 “He who takes Shivambu (one’s own urine) daily and excludes salty, sour and bitter foods from his diet acquires divine accomplishments quickly. Freed from all ailments, and possessing a body comparable to that of Shiva himself, he deports himself like the gods in the Universe for an eternity.”

Sloka 45 – “The Shivambu (one’s own urine) should be boiled in an earthen pot and extracted to one fourth its quantity. It should then be allowed to cool. The extract can be used for whole body message.”

Sloka 48 – “Shivambu (one’s own urine) should be applied to the whole body. It is exceptionally nourishing and can relieve all ailments.”

Sloka 54 – “Unboiled urine should never be used for body message. If the extract of Shivambu is used for message, it is very wholesome for the body. The follower can accomplish many things.”

Of the three texts more traditionally seen as teaching manuals for Yogis, the Hatha Yoga Pradipika is the only one that mentions urine therapy.3 The Gheranda Samhita4 and the Shiva Samhita5 do not.

Hatha Yoga Pradipika

III:96 – “Discard the beginning of the stream of water because it has too much bile. Discard the end of the stream because it is worthless. Wholly enjoy the cool, middle stream. This is Amaroli…”

How is urine made and why?

Urine is the result of blood filtering through the kidneys. In some ways it’s like a run-off valve for overflow, but it’s not really that simple. Sometimes the body spends energy to actively secrete things into the urine that it doesn’t need or want.6

urine collection cup

The kidneys have the very important job of regulating how much water is in the body. They also regulate the amount of salt that is there. Together, the amount of salt and water present form an intimate relationship for physiological balance. If the body has too little water within its blood vessels, it can die of dehydration. If it has too much water, it can die of that too. It’s the same with salt. If there’s too little salt in the body, it can’t function. And if there’s too much salt in the blood and body, that’s definitely toxic.It’s a moment-by-moment thing, with salt and water working to balance each other. After drinking a huge glass of water, most of us who were already in balance will need to go pee pretty quickly. And if we’re sweating in the desert without any water, our kidneys get the picture and stop making urine, or they make dark yellow concentrated urine. They’re very smart that way.

It’s a complicated process though. We’ve evolved to be able to handle not only daily exposure to salt and water, but a whole host of other things that the body needs to regulate to stay in a safe, healthy balance. For instance, the kidneys play a very important part in maintaining the pH of the body by controlling the excretion of hydrogen ions into the urine. If they didn’t and too many accumulated, the body would get acidic and die by slipping into an un-recoverable coma. On the other hand, if the body gets too alkaline, un-stoppable seizures eventually develop leading to death.7

What’s in urine?

Lots of stuff. Urine is mostly water with at least 200 known substances in it. It probably contains thousands more,8 and what’s there will depend not only on what you eat and drink but also on what gets absorbed through your skin and breathed in through your lungs.

Researchers working for NASA in the 1970s thoroughly studied pee in an effort to figure out what to do with it in space. If you’d like more information on the chemical and physical properties of urine than you could possibly need for anything, click here to check out one of their online papers.

Although urine is mostly water, in the following table is a list of 68 substances that comprised 99% of the solute (everything but the water) of urine they collected from 40 to 50 guys over several months.9 They are listed in descending order of concentration: 

Urea

Chloride
Sodium
Potassium
Creatinine
Inorganic sulfur
Hippuric acid
Phosphorus
Citric acid
Glucuronic acid
Ammonia
Uric acid
Uropepsin as tyrosine
Bicarbonate
Creatine
Organic sulfur
Glycine
Phenols
Lactic acid
Calcium
Histidine
Glutamic acid
Androsterone
Methyl-histidine
Magnesium
Imidazole derivatives
Glucose
Taurine
Aspartic acid
Carbonate
Cystine
Citrulline
Threonine
Lysine
Indoxylsulfuric acid
Hydroxyhippuric acid
Hydroxyphenyl hydrocrylic acid
Aminoisobutyric acid
Inositol
Formic acid
Urobilin
Tyrosine
Pyruvic acid
Albumin
Asparagine
Tryptophan
Ketones as acetone
Serine
Alanine
Purine bases
Glycocyamine
Proline
Arginine
Ascorbic acid
Oxalic acid
Bilirubin
Valine
Phenylalanine
Allantoin
Oxoglutaric acid
Leucine
Guanidinoacetic acid
Isoleucine
Urobilinogen
Ethanolamine
Guanidine
Methionine sulfoxide
Dehydroascorbic acid

There are many recognizable substances on the list like calcium, magnesium and potassium. Ascorbic acid and its metabolite at the bottom, dehydroascorbic acid, are plain old vitamin C. The second and third items on the list, sodium and chloride, when combined form common table salt. The substances highlighted in yellow are all essentially amino acids, the alphabet-like building blocks of all proteins in all living things.

Urea and ammonia are related. Ammonia is formed by the breakdown of proteins, and some of it is recycled to make new ones. Ammonia also helps the kidneys and the rest of the body to maintain a healthy pH balance. Like with salt and water, the amount of ammonia in the blood needs to be just right. Any excess build-up is converted into urea. If it’s not, then an elevated level of ammonium ions in the blood (hyperammonemia) is the result. This sometimes happens in newborn babies if they genetically lack the proper mechanism for converting ammonia into urea. A baby without the ability to make the conversion goes into a coma and dies shortly after birth.10 Alcoholics can also die this way when the liver no longer functions after years of abuse, and it stops being able to detoxify ammonia into urea.

Most of the urea gets removed from the body by the kidneys, but one-fifth of it diffuses from blood into the gut. Bacteria in the intestines then change the urea back into ammonia. The ammonia gets absorbed into the bloodstream. It’s taken directly to the liver, which promptly makes urea out of it again and sends it on to the kidneys to be removed from the body.11

So it’s not unusual for the intestines to be exposed to urea and ammonia, similar to the exposure that would occur through ingesting urine. Under most circumstances, the body can adequately handle the additional ammonia and return it to its less toxic form as urea to be excreted.

Uric acid and oxalic acid are two substances produced by the body that can cause toxicity if allowed to build up to high enough concentrations in the blood. The former is thought to cause a form of arthritis known as gout, and this can be seen naturally in some people who are susceptible, whether they are taking on any additional uric acid or not. The latter is seen clinically as a toxin when levels are very high because of the accidental or suicidal ingestion of automobile antifreeze (ethylene glycol). When antifreeze is in the body, more oxalic acid is produced than usual as the liver attempts to detoxify. Unfortunately, the oxalic acid is just as toxic as or more so than the ethylene glycol, and 50 deaths per year on average in the US are caused by its damage to the kidney.10

Androsterone is what the body has broken down testosterone into. There’s no active form of that hormone or any other on the list, just this primary metabolite which is considered to be inactive, meaning that it doesn’t have any physiological effects on the body. (Though there’s some debate about that.)

Is drinking urine good for you?

For sure, several of the substances on that list above are beneficial. Minerals like calcium and magnesium, vitamins like vitamin C, and amino acids with which to build protein can be recovered. For ancient Yogis who may have had restricted access to food, recycling these basic things may have made a lot of sense.

They were pretty smart about it, too, drinking only the middle part. In the hospitals, we ask patients to give us urine samples from mid-stream. The initial flow is often contaminated by bacteria on the skin as it passes. That first bit serves to wash, and the next part of the urine stream is clean. The last part of the urine can have sediment in it like a cup in which dirt has settled to the bottom. The sediment comes out at the end.

Fact: Urine is usually sterile.

Some people are concerned that urine is full of bacteria and other microorganisms that cause disease. That’s simply not true, particularly for young men. As we age, some bacteria do begin to show up in urine and hang out there without causing infection. For young women, 2 or 3 percent will have bacteria in their urine that don’t cause infection, increasing to up to 10 percent by age 70.12

Urea, the primary component of urine, is available as a pharmaceutical known as Ureaphil. It’s used as an osmotic diuretic, meaning that it helps a patient to pee when they are overloaded and sick enough to not be able to handle their fluid balance well on their own. Ureaphil is given intravenously (iv) in a solution with sugar, the latter of which is necessary to prevent lysis of red blood cells that tend to break-up prematurely when high urea concentrations are present. It’s not used very often. In fact, it’s used very rarely, if at all, anymore.12

pollution

Bilirubin is released from red blood cells when they are degraded and removed from the circulation. That happens on a continual basis, with each red blood cell lasting about 120 days in its normal life cycle. Bilirubin is a very effective antioxidant. It protects against free radical damage.10

Not everything that’s in urine made the list above. It includes 99 percent of the bulk of substances found by weight, but that leaves one percent uncharacterized.

One of those unlisted substances is melatonin, a hormone released from the pineal gland after the sun goes down. It’s our darkness signal for the brain, and has a hypnotic effect to get us ready to sleep. It’s also the hormone thought to be responsible for managing our circadian rhythm, the natural cycle of waking and sleeping. It’s found in morning urine13, and may be the reason the Damara Tantra says specifically to drink the first urine of morning before light comes and then sit in meditation. The melatonin may have helped in the development of a trance-like state. Drinking it during daylight hours can mess up the body’s time clock. Recent reports note that melatonin in higher doses has antioxidant effects by scavenging free radicals.14

It’s hard to say what else is in urine that might be helpful. Laboratories haven’t characterized everything, especially those things that are in very, very small amounts. Sometimes it only takes a little bit of something to have an effect, and it’s possible that the effect might be a good one.

Urokinase is an enzyme found in tiny amounts in urine that was isolated and injected into the veins of people having heart attacks. It helps to thin the blood and can break-up clots blocking off arteries. We thought that it was a urinary substance with a good effect, but it’s no longer used because serious problems were found, like it’s ability to cause stroke. It was gone way before my time working in the emergency room. Regardless, it’s an enzyme, so it can’t be taken orally to be effective. If you swallow an enzyme, the stomach acid and digestive juices inactivate it and break it down.

The same is true with antibodies. Some have claimed that drinking antibodies found in urine will boost the immune system by re-circulating those little soldiers. When administering antibodies in the hospital, we have to inject them into veins. If we give them to people to take by mouth, the digestive tract destroys them before they are absorbed and able to make it to their targets.

Some people have claimed that drinking urine can help to fight cancer because of small amounts of special chemicals found in it. Stanislaw R. Burzynski claimed to have isolated one such family of special substances, antineoplastons, that he used to cure patients. Since then both the U.S. National Cancer Institute and the Japanese National Cancer Center have studied antineoplastons and have found them to be totally ineffective. Drug companies, too, have tried to isolate a cancer curing chemical from urine but none have had success.

Myth: Drug companies, which have the most money to fund research, won’t study urine because they won’t be able to make money off of cancer-curing or other chemicals found there. In fact, if they isolate a unique substance found in urine, they will try to patent that, and if they are not allowed, they can tweak the chemical structure only slightly to form a patentable form of it. Then they will have a big money-making drug.

Is urine good for your skin?

The bottle of lotion in my cabinet lists urea it as one of its ingredients. The urea is extracted from urine and added for its softening and hydrating effects. Urea is the main component of urine, accounting for up to half its weight of total solute. There’s up to five times as much urea as the next most bountiful substance, salt.

All the urine collected for the NASA study came from men, but a similar situation occurs in women. There are many hormones in the body, and small quantities of these which make it into the urine may be absorbed through the skin after application. Other substances are likely absorbed, too. Whether or not they are absorbed in significant enough amounts to have any health promoting (or damaging) effects is unclear. Even things we know about, like dehydroepiandrosterone (DHEA), we’re not sure what the overall effects of supplementation on health are at this point.

A few papers have been published since the 1940s showing that urea has some antibacterial effects. Click here for an online version of one of those articles.Urea has also been reported to inhibit the growth of fungus.

Is there anything in urine that can be toxic?

NASA just spent $250 million for a processor that makes urine on the space station safe and palatable to drink. That’s a lot of money, and it doesn’t include all the decades of expensive research that have gone into figuring out how to do it. Makes you wonder, doesn’t it? Why would they spend that kind of dough if fresh urine from a native tap was safe and healthy?

I think one of the best ways to answer the question of toxicity is to take a look at what happens when your kidneys stop functioning. You die. As doctors, we try to help by putting patients on dialysis machines for four hours three times a week to mimic the kidney’s filtering function. Patients with kidney failure live a lot longer with dialysis, but they still die of toxicity from their kidney failure.

shiva

One reason is that all the body’s toxins aren’t filtered efficiently by the artificial dialysis machine the way they are by our own amazing natural filter. Medicine hasn’t yet figured it all out. If you want a peek at how complicated it is, check out this free pdf of a professional paper published by a kidney specialist.

Kidney failure, when the kidneys can no longer clear anything toxic, isn’t exactly the same thing as oral urine therapy, in which toxins as well as vitamins and amino acids are purposefully recirculated to functioning kidneys. Assuming that your kidneys work properly, they may be able to remove again anything you just put back in with your pee beverage. Those onerous little substances will go round and round in a loop. It’s more work for your body to have to get rid of them over and over, but unless you are drinking ALL of your own urine for a long time, nature should be able to handle the job.

Some of the normally excreted toxins are so elusive and complicated that we don’t even have names for them yet, but there are other, more well known, toxins that are in urine also. Pretty much everyone knows about bisphenol A, the widely disseminated compound in plastics, even baby bottles, that’s been linked to reproductive and neuro-developmental problems. According to a 2009 report from the Center For Disease Control (CDC), almost all Americans have some of this chemical in their urine. The kidneys have done their job of filtering it out. The average level in the CDC report was 2.6 micrograms per liter in adults, but levels as high as 18.1 micrograms per liter were found in people. In order to excrete bisphenol A, the body has to link it to glucuronide which makes it less toxic and more easily urinated, but there are intestinal enzymes that cleave the protective bond. Thus, after drinking urine, bisphenol A will get reabsorbed in its active and potentially toxic form.

Arsenic, indisputably a toxin, is found in the urine of almost everyone in concentrations up to 93.1 micrograms per liter in adults.15 It occurs naturally, but we’ve increased the amount of our exposure drastically by burning coal and by using arsenic as a wood preservative.

Pesticides are found in urine, too. The organochlorine pesticides are converted by the liver into new substances in an attempt to make them less toxic, but a less toxic form isn’t always produced. 2,4,6-TCP is a metabolite that’s found in the urine of most people, and it’s been linked to leukemia, lymphoma, and liver cancer.

Here’s a partial list of known and potential toxins in the urine of most people15,16,10:

SUBSTANCE IN URINE

TOXIC EFFECT

Acrylamide

Peripheral neuropathy

Disinfection By-products (DBP)

Possible cancer

Benzophenone-3

Possible reproductive

Bisphenol- A

Possible reproductive/developmental

4-tert-octyphenol

Reproductive problems

2,4-dichlorophenoxyacetic acid (2,4-D)

Non-Hodgkins lymphoma/sarcoma

2,4,5-trichlorophenyoxyacetic acid

Non-Hodkins lymphoma/sarcoma

2,4,5-TCP

Leukemia/lymphoma/liver cancer

2,4,6-TCP

Leukemia/lymphoma/liver cancer

Antimony

Possible cancer

Arsenic

Many effects including cancer

Cadmium

Kidney damage/cancer

Cobalt

Cancer/thyroid problems

Lead

Neurological/developmental problems

Mercury (inorganic)

Kidney damage/acrodynia

Molybdenum

Arthritis

Thallium

Arthritis/neuropathy

Phthalates

Developmental /reproductive/cancer

Naphthalene metabolites

Cataracts/cancer

Phenols

Large array of biological impacts

Indoles

Cardiovascular/kidney damage

Guanidines

Neurotoxic/cardiovascular

Uric acid

Gout

Oxalic acid

Kidney damage

Also, let’s not forget how hard on the body too much table salt (sodium chloride, NaCl) can be. We need to be eating less of it, not taking in extra by recycling urine. The NASA data lists the amount of sodium excretion in urine to be up to 4390 mg per liter. The current recommendation for sodium intake is 2,300 mg or less per day, with many experts advocating an even lower amount of not more than 1,500 mg per day. At the maximum recorded excretion by NASA, drinking one cup (250 ml) of urine provides over 1,000 mg of sodium.

And on one last rather strange note, there’s a medical treatment that may serve as a useful indication of what may happen when urine floods the intestine after ingestion. In some diseases, like spina bifida, the urinary bladder doesn’t function properly. To help those patients, surgeons have been transplanting pieces of intestinal tissue into their urinary bladders in a procedure called an enterocystoplasty. Almost all of the surgical patients develop a subclinical acidosis from the transplanted intestinal tissue absorbing ammonia and chloride from the formed urine back into their blood. It’s thought that the acidosis from ammonia in the urine causes buffers to be leached from bone to balance the pH. Ultimately this results in a progressive demineralization and weakening of bones that leads to osteoporosis. There’s also an increased risk of cancer in patients who have had entercystoplasties. It’s thought to be due to absorption by the transplanted intestinal tissue of some uncharacterized toxin found in the urine to which it is exposed.17

Conclusion

Urine is a filtration product of the blood and it serves as a vehicle for the body to rid itself of extra water, salt and other substances that it doesn’t need. It’s also, along with the feces, one of the main routes of excretion of harmful substances.

While many things in urine are good for you, like vitamin C and amino acids, other substances are not so good for you to drink. It’s a soup made up of thousands of things. We don’t even know exactly what all is in there, and whatever it is, it varies with diet and environmental exposure.

There’s no evidence that drinking urine cures disease or cancer. Plenty of anecdotes exist, but there’s no science. I agree with physician Dr. Andrew Weil, author of Natural Health, Natural Medicine. The perceived effects are likely placebo reactions. Anything that people initially reject as unsavory, like being needled with an injection or drinking pee, has a greater potential for a placebo response than things that don’t give us an emotional charge.

Drinking a little urine isn’t likely to cause harm as long as your kidneys are functioning properly. Pregnant women, those with liver or kidney disease, gout, or cardiovascular disease need to be cautious and check with their physician. Anyone taking medicinal drugs, recreational drugs, or herbal remedies should avoid it.

Topical application of urine may have some healing abilities, and it’s not likely to hurt. There’s a risk of absorbing hormones and other substances the body has chosen to get rid of and which may be harmful. Since it has never been carefully studied in well controlled and designed experiments, it’s hard to say for sure whether or not the benefits outweigh the risks.

Our world is not the same as the one of yogis long ago. Drinking a little early morning urine may have helped their meditation and supplemented an inadequate diet, but environmental pollutants and synthetic chemicals add a dimension of toxicity they did not have to consider. Food is now plentiful in most societies, and there’s no need to supplement vitamin, nutrient, and protein levels with urine ingestion. If supplements are needed, there are better ways to get them.

References

  1. Alter, J. Yoga in Modern India: The Body Between Science and Philosophy. Princeton University Press, 2004.
  2. van der Kroon, C. The Golden Fountain: the Complete Guide to Urine Therapy. B. Jain Publishers, LTD, New Delhi, 2003.
  3. Svatmarama. Hatha Yoga Pradipika. English translation by BD Akers. YogaVidya.com, 2002.
  4. Gheranda Samhita. English translation by J Mallinson. YogavVidya.com, 2004.
  5. Shiva Samhita. English translation by J Mallinson. YogavVidya.com, 2007.
  6. Klaassen CD. Mechanisms of Toxicity. In: Casarett and Doull’s Toxicology: the basic science of poisons. New York: McGraw-Hill 2001.
  7. Guyton AC. Textbook of Medical Physiology. 7th edition. WB Saunders Co., 1986.
  8. Free and Free. Nature and composition of urine from healthy subjects. In: Urinalysis in Clinical Laboratory Practice. CRC Cleveland, Ohio, 1975.
  9. Putnam, DF. Composition and concentrative properties of human urine. NASA Contractor Report, Washington, DC, 1971. Online at: ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/19710023044_1971023044.pdf
  10. Stryker, L. Biochemistry. 3rd edition. WH Freeman and Company. New York, 1988.
  11. Mudge GH and Weiner IM. Agents affecting volume and composition of body fluids. In: Goodman and Gilman’s Pharmacological Basis of Therapeutics. Pergamon Press, New York, 1985.
  12. Barza M. Urinary tract. In: Mechanisms of Microbial Disease. 2nd edition. Williams and Wilkens, Baltimore, 1993.
  13. Graham C et al. Prediction of nocturnal plasma melatonin from morning urinary measures. J Pineal Res 1998 May; 24(4):230-238.
  14. Bonnefont-Rousselot D. and Collin F. Melatonin: action as antioxidant and potential applications in human disease and aging. Toxicology 2010, April 24, epub ahead of print.
  15. Center for Disease Control and Prevention Fourth National Report on Human Exposure to Environmental Chemicals, 2009. http://www.cdc.gov/exposurereport/pdf/FourthReport.pdf
  16. Vanholder, R et al. What is new in uremic toxicity? Pediatric Nephrology 2008;23:1211-1221.
  17. Scales CD and Wiener JS. Evaluating outcomes of enterocystoplasty in patients with spina bifida: a review of the literature. J Urol 2008(6):23-23-2326.
  18. Belanger A et al. Inactivation of androgens by UDP-gluduronosyltransferase enzymes in humans. Trends Endocrinol Metab 2003 Dec:14(10):473-479.
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