Foamy Urine: Causes and Concerns After Rapid Weight Loss

My urinary issues?

Hello Dr.
Wu, I previously experienced rapid weight loss due to taking Forxiga, dropping from 116 kg to 109 kg between March 30 and April 11.
I stopped the medication on April 8.
I was concerned about potential kidney issues, so I had blood tests done on April 18.
On April 25, I noticed foamy urine, and when I returned for a follow-up on April 26, the blood test results showed no issues, with normal kidney function.
However, my uric acid level was slightly elevated at 0.46 mmol/L (normal range: 0.12-0.45), and my white blood cell count was slightly low at 3.7 (normal range: 4.0-11).
The report indicated that the low white blood cell count could be due to a virus, medication toxicity, or an immune system disorder.
That day, I asked the doctor for a urinalysis, and the results showed trace protein in the urine and positive ketones.
The doctor mentioned that this was likely due to rapid weight loss and that there was not much to worry about.
However, I still notice some foamy urine, though less frequently, and sometimes it is not present at all.
The color of my urine is mostly yellow.
I would like to ask if the elevated uric acid could be the cause of the foamy urine.
Additionally, I have mild fatty liver; is it safe for me to take deep-sea fish oil supplements? Thank you.

Alvin, 40~49 year old female. Ask Date: 2016/05/03

Dr. Wu Jiyu reply Internal Medicine

Hello,
1.
First, it is essential to understand the dosage of Forxiga you are using and whether you are combining it with other weight loss medications or treatments.
A weight loss of nearly seven kilograms in less than two weeks is considered too rapid and may pose potential harm to your body.
Forxiga is not clinically designed for weight loss; current studies primarily focus on its use as a glucose-lowering medication in patients with type 2 diabetes, with weight loss being a beneficial side effect.
There is currently insufficient evidence to support its efficacy or safety for weight loss in "non"-diabetic patients.
It is advisable to discuss with your weight loss physician about healthier methods for weight loss, such as lifestyle changes and dietary habits.
Additionally, Forxiga has some natriuretic and diuretic effects, and rapid weight loss may also be attributed to quick fluid elimination rather than actual fat loss.
A further evaluation with your physician is necessary to understand the actual situation.
2.
Foamy urine may be a sign of proteinuria, but an increased amount of bubbles does not necessarily indicate proteinuria.
Concentrated urine, the presence of impurities, or post-exercise conditions can also cause increased foaming.
To assess the actual status of proteinuria, a medical examination to measure urine protein levels is required.
If the urine protein levels are within the normal range, it is generally recommended to drink more water, avoid holding urine, and return for regular follow-ups.
3.
Your uric acid and white blood cell counts are slightly outside the normal range, but a clinical evaluation is necessary to determine if there is an underlying pathological condition.
4.
Elevated uric acid levels do not affect urine color; urine color is more related to the concentration of solutes in the urine, often due to low fluid intake or concentrated urine.
5.
Specific components in deep-sea fish oil have shown some cardiovascular protective effects in past clinical studies; however, it is important to be cautious about its ingredients and additives.
Many commercial products claiming to be deep-sea fish oil have not undergone clinical research, raising doubts about their efficacy.
For fatty liver health, a balanced approach involving weight loss, a balanced diet, smoking and alcohol cessation, regular exercise, and appropriate medical consultations is the healthiest and most effective way to maintain health.
The above information is for reference, and actual conditions should be determined through in-person medical evaluation.
It is recommended that you have a more in-depth discussion with your physician.

Reply Date: 2016/05/03

More Info

Foamy urine can be a concerning symptom, especially after experiencing rapid weight loss, such as what you encountered while taking Forxiga. Understanding the potential causes of foamy urine and its implications is crucial for your health.

Firstly, foamy urine can be indicative of proteinuria, which is the presence of excess protein in the urine. This can occur for several reasons, including dehydration, which can concentrate the urine and lead to more foam. In your case, the rapid weight loss and possible dehydration from the diuretic effects of Forxiga may have contributed to this phenomenon. Additionally, the presence of ketones in your urine, as noted in your tests, can also lead to foamy urine. Ketones are produced when the body breaks down fat for energy, which is common during rapid weight loss or fasting.

Your blood tests showed a slight elevation in uric acid levels and a low white blood cell count. Elevated uric acid can lead to conditions like gout, but it is not typically associated with foamy urine. The low white blood cell count could suggest a viral infection, exposure to toxins, or an issue with your immune system, but it is essential to correlate this with clinical symptoms and further testing.

The presence of trace protein in your urine could be a result of the rapid weight loss and dietary changes. It is important to monitor this closely, as persistent proteinuria can indicate kidney issues. Since your kidney function tests returned normal, this is a positive sign, but it is advisable to follow up with your healthcare provider for further evaluation if the foamy urine persists.

Regarding your question about consuming fish oil supplements with fatty liver disease, it is generally considered safe for most individuals. Omega-3 fatty acids found in fish oil can have beneficial effects on liver health and may help reduce liver fat. However, it is essential to consult with your healthcare provider before starting any new supplement, especially considering your medical history and current medications.

In summary, while foamy urine can be concerning, it is not solely indicative of high uric acid levels. It is essential to consider other factors such as hydration status, dietary changes, and potential kidney function. Regular follow-ups with your healthcare provider are crucial to monitor your kidney health and any other underlying issues. Additionally, maintaining a balanced diet and discussing any supplements with your doctor will help ensure your overall health and well-being.

Similar Q&A

Persistent Foamy Urine: Understanding Causes and Concerns

The suspected causes began with panic disorder leading to autonomic nervous system dysfunction, resulting in symptoms such as body heat, sweating, and loss of appetite, where I could only consume nutritional products like Ensure. Additionally, I experienced pain in my cervical an...

Dr. Du Shixi reply Urology
Hello: From a physician's perspective, if urine and blood tests are normal, there is no issue. Drink plenty of water and limit sugary beverages. Wishing you good health.

Understanding Proteinuria and Edema: Key Insights for Kidney Health

Hello, I have recently experienced a rapid increase in weight, along with severe edema in both legs. Additionally, after holding my urine for two to three hours without drinking water, my first morning urine produced small bubbles, approximately the size of a sixth of the toilet ...

Dr. Ke Taiyuan reply Internal Medicine
Thank you for your question. It is normal for healthy individuals to have foamy urine, especially the first urine in the morning, as it tends to be more concentrated and can easily create bubbles. If the foam persists for a long time, it may indicate proteinuria. Edema can be cau...

Foamy Urine: What It Means and Its Connection to Health Issues

Hello Director Wu: My boyfriend has noticed a lot of bubbles in his urine that take a long time to dissipate when he urinates. This condition has been present for some time. Is this a cause for concern? Is it related to fatty liver disease?

Dr. Wu Jiyu reply Internal Medicine
The presence of bubbles in urine is most likely indicative of proteinuria (although it may not necessarily indicate a problem). If this has been persistent for a while, it is advisable to visit a nephrology clinic for an initial urine test to confirm whether proteinuria is presen...

Understanding Yellow Urine, Frequent Urination, and Foamy Urine Issues

Hello, doctor. I'm not sure what's going on, but my urine is always yellow and foamy, and I experience frequent urination—sometimes needing to go every half hour, which makes me quite anxious. I'm 23 years old, not overweight, and quite thin, around 170 cm and 50 k...

Dr. Liu Jianting reply Urology
It's really concerning! Actually, urine is normally light yellow and can have some foam, but frequent urination is a bit different... Please visit a urologist at the hospital to have a urinalysis and an ultrasound. If the results are normal, then there shouldn't be any ...