Urine Urobilinogen (Dipstick)
A byproduct of bilirubin that normally shows up in small amounts in urine. A dipstick gives a rough check of it as part of a urinalysis.
AI-drafted. Awaiting verificationAlso called UBG, UROLOINC 20405-7
What it is
Urobilinogen forms in your gut when bacteria break down bilirubin, a yellow pigment made when old red blood cells are recycled. Some is absorbed back into the blood, a small amount leaves in the urine, and the rest leaves in stool. Many dipsticks report it in steps, for example Normal (about 0.2), 1, 2, 4 and 8 mg/dL. Some labs print Ehrlich units (EU/dL) instead, which labs treat as equal to mg/dL on a dipstick.
Why it matters
Urobilinogen links your red blood cells, liver, bile ducts and gut. The amount in urine can rise when red blood cells are breaking down faster than usual or when the liver is not clearing it. It can fall when bile can't reach the gut. A dipstick is only a rough check, though. It can't tell low from normal, and blood tests such as ALT, AST and bilirubin give a clearer picture of liver health.
If it’s low
A dipstick usually can't tell a low level from a normal one, because its lowest step is read as normal. Little or no urobilinogen can happen when bile can't reach the intestine, or when the gut bacteria that make it are reduced. A dipstick is not a reliable way to check for this.
Common causes
- Antibiotic use, which reduces the gut bacteria that make urobilinogen
- Blocked bile flow from the liver or gallbladder into the intestine
- A sample that was stored badly or treated with a preservative, which can read falsely low
What can help
- Ask your clinician whether liver blood tests would help if you have symptoms such as pale stools or yellowing of the skin or eyes
If it’s high
A higher reading means more urobilinogen than usual reached your urine. Small increases are common, even in people whose liver tests are normal, and some medicines can make the strip read high. A clearly higher result can be linked to faster red blood cell breakdown or to a liver that is not clearing urobilinogen well, so your clinician will look at it with your other results.
Common causes
- Normal variation, since mildly raised results are not rare in people with normal liver tests
- Medicines that react with the test, such as phenazopyridine (a urinary pain reliever that colors urine) and sulfonamide antibiotics
- Faster breakdown of red blood cells (hemolysis)
- Liver conditions such as hepatitis, cirrhosis or liver damage from medicines
- Rarely, an acute porphyria attack, because the strip chemistry also reacts to a related substance called porphobilinogen
What can help
- Tell your clinician about every medicine and supplement you take, since some can change the strip
- Ask whether liver blood tests (such as ALT, AST and bilirubin) or a blood count would help put the result in context
- Give a fresh sample and get it to the lab promptly
Usual ranges
What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.
For adults: up to 1 mg/dL. Source: Labcorp, MedlinePlus Medical Test (NIH National Library of Medicine), American Family Physician, Scientific Reports, Nagoya Journal of Medical Science, NIH National Library of Medicine (Lister Hill National Center for Biomedical Communications), Cureus (urinalysis table with the treating hospital's reference intervals), Case Reports in Endocrinology (urinalysis table with the treating hospital's reference intervals), Regenstrief Institute (UCUM).
- Adults (this one applies)up to 1 mg/dL
Sources: Labcorp, MedlinePlus Medical Test (NIH National Library of Medicine), American Family Physician, Scientific Reports, Nagoya Journal of Medical Science, NIH National Library of Medicine (Lister Hill National Center for Biomedical Communications), Cureus (urinalysis table with the treating hospital's reference intervals), Case Reports in Endocrinology (urinalysis table with the treating hospital's reference intervals), Regenstrief Institute (UCUM)
What can affect your result
- Medicines and substances that react with the strip, including phenazopyridine and sulfonamide antibiotics
- Antibiotics, which can lower urobilinogen by reducing gut bacteria
- Storage: samples that sit too long, or contain preservatives, can read falsely low
- Conditions that change red blood cell breakdown or bile flow
- How your lab prints the result: mg/dL, Ehrlich units (EU/dL) or µmol/L
- Phenazopyridine (a urinary pain reliever that colors urine) and sulfonamide antibiotics can make the strip read high.
- Porphobilinogen, a substance that builds up during an acute porphyria attack, also reacts with the strip chemistry.
- A sample that sits too long, or that contains a preservative, can read falsely low.
Reflects the current sample. It can shift from day to day.
When to talk to a clinician
A higher urobilinogen result on its own rarely needs urgent care. Contact a clinician soon if you have yellowing of the skin or eyes, dark urine with pale stools, itching, ongoing belly pain or unusual tiredness. Get urgent care for confusion, or for severe belly pain together with yellowing of the skin or eyes.
Questions you could ask
- How does this result fit with my urine bilirubin and my liver blood tests?
- Could a medicine or supplement I take be affecting this strip?
- Would liver blood tests or a blood count help put this result in context?
- Is this result worth following up, given that a dipstick can't separate low from normal?
Questions people ask
Why does my report say 'Normal' or 0.2 instead of a number?
Dipsticks read urobilinogen in steps, and the lowest step is reported as Normal or about 0.2 mg/dL. A small amount in urine is expected, so 'Normal' and 0.2 mean the same thing.
What if mine says 1.0 or 2.0?
Labs differ. Many treat up to 1.0 mg/dL as in range, and some flag only 2.0 or more. A step or two above normal is fairly common and often has no clear cause. Your clinician will look at it with your symptoms, your urine bilirubin and your liver blood tests.
What are Ehrlich units?
They are an older unit still used on some dipstick reports. On a urinalysis, 1 Ehrlich unit per dL (EU/dL) is treated as 1 mg/dL, so 'EU/dL' and 'mg/dL' mean the same thing.
Can this test tell me if my liver is healthy?
Not by itself. A dipstick is a rough check, and it can read higher or lower for reasons that have nothing to do with the liver. Liver blood tests such as ALT, AST and bilirubin give a clearer picture.
Show the science and sources
Units
- 1 mg/dL = 1 mg/dL
- 1 mg/dL = 1 EU/dL
- 1 mg/dL = 16.87 µmol/L
For clinicians and researchers
Urobilinogen forms when intestinal bacteria reduce conjugated bilirubin. Most is lost in stool, part is reabsorbed into the portal circulation and re-excreted in bile, and a small amount is filtered by the kidney. Dipsticks use Ehrlich-reagent chemistry and read in steps (commonly Normal, 1, 2, 4 and 8 mg/dL, or Normal, 35, 70, 140 and 200 µmol/L on at least one strip brand (Song 2023)). One Ehrlich unit is treated as 1 mg of urobilinogen per dL, so EU/dL and mg/dL are printed interchangeably. UCUM defines [EU] only as an arbitrary unit, while NLM's UCUM-LHC library lists mg{urobilinogen}/dL as a synonym. Ehrlich chemistry also reacts with porphobilinogen, so a strip can read falsely high during an acute porphyria attack (Song 2023), and AAFP (2022) lists phenazopyridine and sulfonamides as causes of false-positive results. AAFP (2022) lists improper storage and preservatives as causes of false-negative results. Because the lowest step is read as normal, a strip can't confirm reduced or absent urobilinogen, as in complete biliary obstruction. AAFP (2005) notes that hemolysis and hepatocellular disease can raise urobilinogen and that antibiotic use and bile duct obstruction can lower it. Mildly positive results are not rare in healthy people: in a Japanese cohort of 5,151 adults aged 35 to 69, 9.3% of men and 3.6% of women had a positive strip (Kataoka 2011). Lab limits vary: 0.2–1.0 mg/dL (Labcorp and many hospital labs), under 2.0 mg/dL (some), or only 'Normal'. Liver blood tests are the usual way to assess hepatobiliary disease.
LOINC 20405-7 (primary), 50563-6, 19161-9, 34928-2, 3107-0, 5818-0. Specimen: urine.
Sources
- Urinalysis, Routine With Microscopic Examination on Positives: sample report (test 003038), Labcorp (2026)
- 003038: Urinalysis, Routine With Microscopic Examination on Positives, Labcorp
- Urobilinogen in Urine, MedlinePlus Medical Test (NIH National Library of Medicine)
- Urinalysis: A Comprehensive Review, American Family Physician (2005)
- Office-Based Urinalysis: A Comprehensive Review, American Family Physician (2022)
- A high urinary urobilinogen/serum total bilirubin ratio indicates acute hepatic porphyria in patients with abdominal pain, Scientific Reports (2023)
- Association of UGT1A1 Gly71Arg with urine urobilinogen, Nagoya Journal of Medical Science (2011)
- Urobilinogen (CID 26818), molecular weight 592.7, PubChem (NIH National Library of Medicine)
- The Unified Code for Units of Measure, §45 arbitrary units: [EU], Ehrlich unit, Regenstrief Institute (UCUM)
- UCUM-LHC unit definitions: [EU] Ehrlich units (urobilinogen), synonyms EU/dL and mg{urobilinogen}/dL, NIH National Library of Medicine (Lister Hill National Center for Biomedical Communications)
- Unusual Presentation of Bladder Cancer in a Young Male With Significant Tattoo Exposure: A Case Report, Cureus (urinalysis table with the treating hospital's reference intervals) (2024)
- Unraveling the Complexity of Non-typhoidal Salmonella Genitourinary Infection in HIV: A Case Report and Management Strategy, Cureus (urinalysis table with the treating hospital's reference intervals) (2025)
- An Emerging Human Pathogen: Raoultella Planticola, Cureus (urinalysis table with the treating hospital's reference intervals) (2025)
- An Unusual Presentation of Diverticular Colovesical Fistula: Acute Renal Failure With Bilateral Emphysematous Pyelonephritis, Cureus (urinalysis table with the treating hospital's reference intervals) (2025)
- Givosiran for the Treatment of Hereditary Coproporphyria in Pregnancy: A Case Report, Cureus (urinalysis table with the treating hospital's reference intervals) (2026)
- An Infant With Hyponatremia, Hyperkalemia, and Faltering Growth: A Case Report, Case Reports in Endocrinology (urinalysis table with the treating hospital's reference intervals) (2026)
AI-drafted. Awaiting verification. Last reviewed 2026-10-03. How we build and check these pages.