Lyme disease is an infection caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of an infected black-legged tick. A common point of confusion arises about whether this bacterial infection can directly cause a change in urine color. Understanding the true relationship between the infection, its treatment, and any resulting discoloration requires separating the effects of the microbe from the effects of the medicine used to fight it.
Lyme Disease: Is Urine Color a Symptom?
The infection caused by Borrelia burgdorferi does not typically produce a specific change in urine color that is recognized as a primary symptom. Common signs of early Lyme disease focus on systemic issues like fever, headache, body aches, and the distinctive expanding erythema migrans rash. Urine color is primarily determined by the concentration of urochrome, a waste product, and the body’s overall hydration level.
A change in urine color is generally not listed among the standard indicators for diagnosing Lyme infection itself. However, a severe dark discoloration can occur if a person is co-infected with another tick-borne illness, such as babesiosis. Babesiosis can lead to hemolytic anemia, which involves the destruction of red blood cells, resulting in dark or tea-colored urine due to the presence of blood byproducts. This distinction is important because the same tick bite could have transmitted a co-infection that does affect urine color, even if Lyme itself does not.
Medication Effects on Urine Color During Treatment
The most frequent reason for a change in urine color during Lyme disease treatment is the antibiotic medication. Doxycycline, a tetracycline antibiotic often prescribed for early Lyme, is known to potentially cause dark urine as a side effect. This discoloration is usually a temporary and benign reaction to the drug being metabolized and excreted by the body.
Similarly, amoxicillin, a penicillin-class antibiotic sometimes used to treat Lyme, may also be associated with changes in urine color. In rare instances, amoxicillin can cause crystals to form in the urine, while more commonly, it can be linked to dark urine or changes indicating a liver response. Another antibiotic, Azithromycin, can also cause dark-colored urine. These color shifts are typically not a sign that the infection is worsening but rather a common pharmacological effect of the medication.
When to Be Concerned About Urine Discoloration
While drug-induced color changes are common, certain types of discoloration warrant immediate attention from a healthcare provider. Urine that appears red or pink is concerning because it can indicate the presence of blood, known as hematuria. Hematuria can be a rare adverse effect of amoxicillin, or it may signal a more serious issue like a kidney stone or a urinary tract infection.
Very dark brown or tea-colored urine, especially when accompanied by pale stool or yellowing of the skin or eyes, should be reported promptly. This combination of symptoms can indicate issues with liver function, which can occur as a rare side effect of certain antibiotics, like Doxycycline. Severe dehydration from fever or illness can also concentrate urine to a dark color, which requires immediate attention to restore fluid balance. Any persistent or unusually colored urine that lasts more than a few days after starting medication should be discussed with a medical professional.