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Complementary and alternative medicine Friday Woo Medicine Quackery Skepticism/critical thinking

Your Friday Dose of Woo: The pause that refreshes and heals

Glutton for punishment that I am, all in the name of skepticism, critical thinking, and evidence-based medicine, I am sometimes wont to surf through the stranger parts of the Internet in search of truly amazing material for Your Friday Dose of Woo. Sometimes, I hit the jackpot, as I did a few weeks ago. Sometimes I don’t. Regardless, I’m always amazed at the strangeness that I encounter. This week, I was pondering what topic to cover. Once again, there were so many possibilities that I was having a hard time making up my mind, even more so than usual. While contemplating this dilemma, I felt the call of nature.

Heading to the commode, I was still trying to decide between so many different varieties of woo. And then, during the pause that refreshes, I remembered something. This was a topic that came up from time to time back on Usenet on misc.health.alternative. It was a practice that I always had a hard time understanding (much less stomaching), and I realized that I’ve never discussed it before, either on this blog or my previous blog.

I’m talking about urine therapy.

Apparently there’s a fairly significant contingent of alties who believe that drinking their own urine (or, almost as disgusting, rubbing it on their skin–or even more disgusting still, still, boiling it and concentrating it and then rubbing it on their skin) is a panacea that can treat or even cure many diseases or conditions. I know what you’re thinking. I just told you about how obsessed some alties are about their own waste, going so far as to undergo colon cleanses to “purge” the waste supposedly stuck to the lining of their colon that (they believe) are slowing “poisoning” with their own waste and even undergoing purges that supposedly “cleanse” the liver of toxins. Why, then, would many of them then willingly ingest their own liquid waste in the belief that it will “heal” them of many disease?

Damned if I know.

I also know one other thing that you’re probably thinking: Why do I focus so much on excretory bodily functions in Your Friday Dose of Woo? Think about it. I’m a surgeon. Surgeons pay lots of attention to bowel and bladder function because they’re very important in determining how a patient is doing after surgery. If any of you have ever had bowel surgery or even just abdominal surgery before, ask yourself: What did your surgeon ask you each and every day after surgery? I bet you know the answer: Did you pass gas? Did you have a bowel movement yet? And we also frequently ask whether you can urinate without difficulty. Maybe it’s just habit, and I can’t help myself. But, I would point out, it’s the freakin’ alties who are coming up with these “therapies,” not me. Finally, it gives me the opportunity to trot out all sorts of bad bathroom humor. (What that says about me I leave as an exercise for the reader.)

In any case, if you listen to the pee drinkers (which is what we used to call them on misc.health.alternative), you’ll soon find that there’s nothing that that liquid gold can’t do:

Urine is considered to be an invaluable source of nourishment and healing that perhaps has been too controversial or not financially rewarding enough for it to be talked about and encouraged as a potent medicine. One’s own urine, a living food, contains elements that are specific to one’s body alone. The body is constantly producing a huge variety of antibodies, hormones, enzymes and other natural chemicals to regulate and control its functions and combat imbalances that one may not be aware of.

Clinical studies have proved that the thousands of critical body chemicals and nutrients that end up in urine reflect the individual body’s functions. When re-utilised, these chemicals and nutrients act as natural vaccines, antibacterial, antiviral and anticarcinogenic agents as well as hormone balancers and allergy relievers. The information that urine contains therefore cannot be duplicated or derived from any other source. Just as nature produces no two people who are exactly the same, there are no two urine samples in the world that contain exactly the same components.

“Don’t take this therapy lightly. 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. After you overcome your initial gag response (I know I had one), you will realize that something big is going on, and if you are searching for health, this is an area to investigate. There are numerous reports and double blind studies which go back to the turn of the century supporting the efficacy of using urine for health.”

There, now. Doesn’t that sound as though it’s worth it to drink your own pee to get all those benefits? Still not convinced? Then how about this testimonial from a woman with multiple medical conditions:

This natural therapy became, for me, a priceless gift of health, as it has for many others. It gave the fastest, most dramatic results of any natural or manmade medical treatment I have ever tried and was truly the miraculous happy ending to my long story of illness and failed medical treatments. By using this simple, natural medicine, along with other natural healing approaches such as homoeopathy, herbs, good nutrition and rest, I have been able to remain consistently disease-free and I feel better and stronger than I have ever felt in my life since that fateful day in July so many years ago.

Amazing, eh? Given that most of us produce a couple of liters a day of this fantastic substance, it’s amazing that doctors and pharmaceutical companies have even bothered to develop drugs. Heck, if, as urinophiles claim, urine’s powers have been recognized for thousands of years, one wonders why all those traditional healers bothered with herbs at all! After all, if you can cure any disease and promote such fantastic health just by drinking your own pee, you’d think that it would be obvious to all. If that wondrous golden fluid has such powerful healing effects, you wouldn’t need a controlled, randomized, double-blind trial to detect them.

So what is the concept behind urine therapy? Well, alties seem to have the strange idea that, because urine comes from an ultrafiltrate of blood, it is something akin to the distilled essence of blood. All of it seems to come down to a mystical thinking about “life essence.” Blood is often viewed in such a way, and the writings advocating urine drinking often ascribe magical-sounding powers to the yellow fluid. This urine worship is usually coupled with a profound misunderstanding of what urine is, as shown here:

Urine is not, as many believe, the excess water from food and liquids that goes through the intestines and is ejected from the body as “waste”. It is much different and much more. When you eat, the food you ingest is eventually broken down in the stomach and intestines into extremely small molecules. These molecules are absorbed into tiny tubules in the intestinal wall and then pass through these tubes into the blood stream.

The blood circulates throughout your body carrying these food molecules and other nutrients, along with critical immune defense and regulating elements such as red and white blood cells, antibodies, plasma, microscopic proteins, hormones, enzymes, etc., which are all manufactured at different locations in the body.

As the blood circulates, it passes through the liver where toxins are removed and later excreted from the body in the form of solid waste. Eventually, this now purified “cleaned” blood makes its way to the kidneys. When blood enters the kidneys it is filtered through an immensely complex and intricate system of minute tubules called nephron through which the blood is literally “squeezed” at high pressure. This filtering process removes excess amounts of water, salts and other elements in the blood that your body does not need at the time.

These excess elements are collected within the kidney in the form of a purified, sterile, watery solution called urine. Many of the constituents of this filtered watery solution, or urine, are then reabsorbed by the nephron and delivered back into the bloodstream. The remainder of the urine passes out of the kidneys into the bladder and is then excreted from the body.

The very first sentence of the above passage is wrong. Urine is your waste. Yes, it is 95% water plus electrolytes filtered from the blood. But it is also roughly 5% nitrogenous waste, mainly in the form of urea. When you drink your own pee, you’re basically recycling the nitrogenous waste again, forcing your kidneys to do the work of excreting it yet again. (In the military, they refer to this sort of thing as “paying for the same real estate twice.”) It is true that drinking your own urine is harmless in small amounts, but if you drink a lot of it, reingesting the nitrogen-containing compounds your body was trying to eliminate, these nitrogenous wastes can accumulate. Among the functions of the kidneys include: excreting nitrogenous waste, adjusting the pH of the blood by regulating the excretion of bicarbonate ion in the urine, regulating the electrolyte composition of the blood by either holding onto or excreting appropriate electrolytes, and regulating blood volume by making the urine either dilute or concentrated. All of these are critical functions. Indeed, in renal failure, there are serious electrolyte disturbances (primarily a buildup of postassium, which the failing kidneys can’t excrete and which, when the blood level of potassium gets too high, can cause cardiac arrhythmias and even cardiac arrest).

Alties also like to link urine with amniotic fluid, again connecting it to some sort of life essence in the womb, the substance that bathes and protects the developing fetus:

As medical researchers have discovered: “Urine is the main component of the amniotic fluid that bathes the human fetus. Normally the baby ‘breathes’ this urine-filled amniotic fluid into its lungs. If the urinary tract is blocked, the fetus does not produce the fluid, and, without it, the lungs do not develop.” (G. Kolata, “Surgery on Fetuses Reveals They Heal Without Scars”, The New York Times, Medical Section, 16 August 1988)

While it is true that there is a large amount of fetal urine in amniotic fluid, that does not make it the same thing. Also, although it is true that amniotic fluid is required for fetal lung development and that it is made up largely of fetal urine, it does not follow from these observations that urine will do anything postnatally when ingested. Of course, if alties really want to follow that logic, they would try to breathe in their own urine, but sadly the result would be the same as if they tried to breathe in water–not pleasant.

In any case, all urine really is is nothing more than unneeded electrolytes in water, plus leftover nitrogen waste, particularly urea. It also contains small amounts of ammonia and even formaldehyde, along with traces of a variety of subtances, vitamins, cytokines, and proteins at low concentrations. The urinophiles are correct about one thing: Urine is not toxic generally, and it is sterile in the absence of urinary tract infection. Of course, it is also an excellent bacterial culture medium; so if it’s left to sit around for too long it will grow bugs. Lots of bugs. That’s one reason why it starts to stink after several hours if you urinate but don’t flush. It’s also why urinophiles like their favorite life-giving beverage “fresh from the tap,” so to speak. In any case, as urinophiles are fond of pointing out, people trapped in collapsed buildings or at sea can prolong their lives by drinking their own urine. True enough, but that’s because drinking urine in such a case decreases the overall rate of fluid loss from the body because fluid that would otherwise be lost is being reingested. It does not follow from the observation that drinking one’s urine when no water is available will prolong life that urine has any sort of miraculous life-giving properties. (Drinking water would be much better.) Nor does it follow that doctors and those evil pharmaceutical companies are trying to hide urine’s supposedly miraculous properties from people, while studying compounds in urine that might be useful therapeutically:

Then there’s the research into wounds and burns using urea (the primary solid component of urine). As only one research study among many reported: “In America, urea has been used for the treatment of various infected wounds and it has been found to be extremely efficient…even the deepest wound can be treated effectively…. Urea treatment has been successful where other treatments have failed. For external staph infections we found urea preferable to any other dressing…there are no contra-indications to its use.” (Dr. L. Muldavis, 1938, Royal Free Hospital, London).

Now these medical reports are only a few of the more than 50 research studies I compiled and published in the book Your Own Perfect Medicine, but they certainly give an indication of the importance of what we’ve never been told about urine by the medical community. As far back as 1954, the Journal of the American Medical Association (July issue) reported that “More scientific papers have probably been published on urine than on any other organic compound.” Another publication revealed that “more than 1,000 technical and scientific papers, related only to low molecular weight substances in urine, appeared in medical and scientific literature in one single year.” All this fuss about a substance that we’re told is nothing more than a body waste?

Note the year of one of the references cited: 1938. I like to think that medical science has progressed considerably in 68 years myself, but maybe that’s just me. Given that many alties still cite Bechamps, who was a contemporary of Louis Pasteur, as an authority, I have to guess that they like their science out of date. In any case, the observation that there are useful compounds in urine worth studying does not imply that drinking your own urine will provide you with enough of them to have an effect. Moreover, all the “vitamins” and “nutrients” in urine got there because they weren’t needed. That’s one of the key problems with a lot of the claims for vitamin C therapy, for example. Vitamin C is a water-soluble vitamin; excess is rapidly eliminated by the kidneys into the urine. The very reason it’s there in the first place is because the body didn’t need it and doesn’t have a mechanism to store it. Indeed, the fallacy in thinking is not just limited to nutrients, an example of which can be found here:

One of the useful components that urine contains are enzymes. Urine contains many enzymes, one of which is called Urokinase. While doing research on this enzyme, scientist found that Urokinase causes vasodilatation and resembles nitroglycerine in its ability to strengthen the bloodstream from the coronary artery to the cardiac muscle. Today, Urokinase is used in drug form and sold as a miracle blood clot dissolver for unblocking coronary arteries. The existence of enzymes such as Urokinase in urine, might explain why urine therapy is said to be effective against arteriosclerosis, heart attack, pulmonary embolism, etc..

Point number one: It’s highly unlikely that there is enough urokinase to have a therapeutic effect in a glass of urine. Urokinase as used in, for example, acute myocardial infarction, is given at huge dosese, doses that add up to 100,000 units or more over 12 hours. These are amounts many orders of magnitude greater than what can be found in anyone’s urine. Point two: urokinase is a freakin’ enzyme! That means it’s a protein. It’s denatured and rendered inactive by stomach acid, and then in the small intestine digestive enzymes break it down to much smaller peptides and ultimately to amino acids. There’s would be no active enzyme absorbed after ingestion even if there were enough enzyme in a glass of pee to have a therapeutic or preventative effect.

Finally, drinking one’s own urine is not without unpleasantness other than the fact that you’re drinking your own urine. As described in the Encyclopedia of Alternative Medicine:

Side effects can include headache, diarrhea, itch and rashes, pain, fatigue, soreness of the shoulder, and fever. An increase in symptoms of the specific illness may also occur. These symptoms can last from a week to six months. Starting the therapy with small doses can alleviate some of these side effects.

I doubt about the “increase in symptoms of the specific illness,” but I have little doubt that drinking your own pee could cause headache, diarrhea, itch, and rashes. Hmmm. Maybe there is a consistency after all. Drink your own pee and clean out your colon at the same time. Yeah, that’s the ticket.

Naahhh. It still doesn’t make any sense.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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