When Clear Urine is a Good Sign & When it is Bad

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The Short Anwer:

Clear urine (colorless pee) can be a good or bad sign depending on the cause and associated symptoms. It is considered a good sign when it is due to caffeine, medications, or excess water intake. And considered bad when it is due to diseases such as diabetes mellitus and diabetes insipidus.

Quick Summary:

• Clear urine is often a sign of increased urine volume (polyuria).
• Clear urine is considered a good sign when it is due to the following:
  • Good hydration.
  • Induced by drugs (diuretics).
  • Due to caffeine intake.
  • Pregnancy (provided that no other symptoms are present).
• Clear urine is considered a bad sign when it is due to the following:
  • Diabetes mellitus.
  • Diabetes insipidus.
  • Kidney disease.
  • Hypercalcemia.
  • Cushing’s syndrome.

Table of Contents

[A] When is clear urine a good sign?

The following are the common conditions in which clear urine can be a normal or good sign:

• If clear urine is a sign of good hydration.
• If you are taking drugs that increase urine output (diuretics and other medications).
• If clear urine is experienced after caffeine.
• If clear urine is associated with pregnancy.

And here is a breakdown for each condition:

1. Clear urine is a sign of hydration.

Clear (light-colored or water-like urine) is most commonly caused by drinking excess water (or other fluids such as soft drinks, alcohol, or fruit juices).

Excess fluid intake is the most benign condition that produces clear (pale-colored or water-like) urine. And it is a good sign as it means you are not dehydrated.

Drinking too much water is rarely a problem as your body secretes excess water through the kidneys.

The urine typically reverts to its normal amber-yellow color when you stop over-drinking.

2. Clear urine mean your medications are working.

Sometimes, clear urine is a sign of drug-induced excess urine production. Therefore, drug-induced diuresis (with subsequent clear urine) is a desirable medical effect for many drugs.

So, clear urine in such a case is a good sign. Examples include:

• Antihypertensive medication with a diuretic effect.
• Diuretic medications to treat heart disease (such as heart failure).
• Anti-diabetic medications that increase the amount of urine (such as empagliflozin, dapagliflozin, etc.).

The list of drugs that may cause polyuria and clear or colorless urine are:

• Diuretics such as furosemide (Lasix@), Aldactone, hydrochlorothiazide etc.
• Some antihypertensive medications include Cardura, Amlodipine (Norvasc®), and Felodipine (Plendil®).
• Some diabetes medications such as Dapagliflozin (Farxiga), canagliflozin (Invokana®), and empagliflozin (Jardiance).
• Tamsulosin (Flomax®) used for the treatment of being prostatic hypertrophy (BPH).
• Antidepressants such as escitalopram, sertraline, and fluoxetine.
• Benzodiazepines (for treatment of insomnia and anxiety) such as diazepam (Valium®).
• Intravenous saline, hypertonic saline, and mannitol.

3. Caffeine.

Caffeine is a strong diuretic. Therefore, high-caffeine beverages (such as coffee and energy drinks) typically increase urine volume with subsequent clear or pale-colored urine.

Clear urine after caffeine intake is not considered a bad sign. Caffeine has many health benefits if consumed in moderation.

4. Pregnancy.

During pregnancy, your blood volume increases significantly (, especially in the last months of pregnancy. Also, your kidney increases its urine filtration rate by up to 50%.

So, The urine of pregnant women may appear lighter or clear in color in many instances. It is considered a good sign (no dehydration) unless associated with other symptoms such as thirst sensation, dizziness, or hunger (denoting gestational diabetes).

How to know if clear urine is a good sign:

• Clear urine is not associated with other urinary symptoms such as burning urination, incontinence, or bladder pain.
• There is an obvious cause that explains it (drinking lots of water, caffeine, or taking medication).
• There is no extreme thirst or signs of significant water loss.
• No weight loss.
• No fever,
• No unexplained hunger or fatigue.
• No foamy urine.
• No blood or blood clots in urine.

[B] When is clear pee a bad sign?

As we mentioned above, many causes of clear (colorless) urine are due to benign conditions. However, clear (crystal-clear) urine can also be a bad sign.

Some diseases may lead to excess urine and/or loss of the ability of your kidney to concentrate urine. This ultimately results in large volumes of urine that are typically clear or colorless, like water.

Clear urine is considered a bad sign when it is due to the following:

• Diabetes mellitus (uncontrolled or undiagnosed).
• Diabetes Insipidus.
• Kidney diseases.
• Excess alcohol.
• Hypercalcemia.
• Cushing’s syndrome.
• And others.

1. Diabetes mellitus.

Diabetes mellitus refers to the increase in blood sugar (glucose) levels. In addition, patients with undiagnosed diabetes often present with polyuria (frequent urination of large amounts of clear urine without drinking water), thirst sensation, and progressive weight loss.

Poor compliance to diabetes treatment, diet, and other diabetes complications, such as diabetic ketoacidosis, can present with polyuria of clear urine which is considered a bad sign in such patients.

2. Diabetes insipidus.

Polyuria (excess clear urine) occurs when the ADH hormones are decreased (central diabetes insipidus) or become ineffective due to defects in the kidney receptors (nephrogenic diabetes insipidus). Learn More.

patients with diabetes insipidus experience frequent, large fol

3. Hypercalcemia.

Excess calcium, as with parathyroid tumors, malignancy (multiple myeloma) causes excess, diluted urine that appears clear.

4. Cushing’s syndrome.

Cushing’s disease is typically caused by an adrenal gland tumor secreting excess corticosteroids. As a result, patients with Cushing’s disease usually have polyuria and clear urine.

Symptoms denoting that clear urine is a bad sign.

Consider clear urine as a bad sign when it is associated with one or more of the following:

• Polyuria (large urine volume) is persistent for several days without excess fluid intake.
• Persistent clear urine for days or weeks.
• Recurrent thirst sensation.
• Foamy urine.
• Abdominal pain, nausea, or vomiting.
• Fever.
• Unexplained hunger (polyphagia).
• Unexplained weight loss.

• Evidence-based
• Written by a doctor.

MD, Internal Medicine and Nephrology specialist.

Dr. Esraa A. MagidAuthor

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