Cloudy urination is urine that looks milky or cloudy, like rice water or diluted milk. In some cases, urine may appear clear but will form a cottony flocculent sediment if allowed to stand. By definition, cloudy urination does not cause discomfort or pain during urination. When pain is present, the condition is usually called cloudy painful urination.
Cloudy urine is caused by a failure of the "turbid and pure" components of urine to be separated. The kidneys and bladder qi are responsible for processing waste fluids, separating the waste (turbid) portion for excretion from the reusable (pure) portion that is sent to the lungs to continue the fluid metabolism cycle. When the kidneys are too weak or the process is interrupted by a pathogen, the turbid and pure components of urine are not properly separated, leading to cloudy urine.
An external damp-heat pathogen that invades the body through the bladder channel, the leg yin channels, or the local channels and collaterals can disrupt qi transformation in the bladder. This can cause acute painful urination and, if left unresolved or becomes chronic, can lead to cloudy urine.
Excessive consumption of rich, oily foods and alcohol can introduce damp-heat directly into the body. This damp-heat can sink into the lower burner and disrupt qi transformation. On the other hand, a diet high in cold, raw foods, hard-to-digest foods, or irregular eating habits can weaken the spleen, leading to qi and blood deficiency and the generation of dampness. This dampness can then stagnate and create heat, or combine with any preexisting heat in the body from yin deficiency, chronic liver qi constraint, or yang excess, to create damp-heat.
Frequent or excessive use of antibiotics or bitter, cold herbs in the treatment of recurrent heat patterns can also weaken the spleen and eventually the kidneys, causing qi deficiency and dampness that interferes with qi transformation.
Frustration, resentment, sexual tension, repressed emotions, and stress can impair the distribution of liver qi and the movement of lower burner qi, as the liver channel passes through and regulates the lower burner to some extent. Over time, constrained qi in the lower burner can lead to blood stasis. When blood stasis affects the bladder and lower burner, qi is seriously compromised.
Chronic qi constraint is often complicated by other factors that contribute to cloudy urine. Emotions that contribute to constrained qi can smolder in the liver and create heat, which can be transmitted through the liver channel to the lower burner or combine with dampness to create damp-heat. Constrained qi can also rebel sideways and invade the spleen, contributing to qi deficiency and the development of dampness, which can sink into the lower burner and potentially generate heat, establishing a damp-heat cycle.
Exhaustion, Overwork, Constitutional Factors
Overwork, worry, or excessive mental activity combined with irregular dietary habits and a sedentary lifestyle can weaken spleen qi. The spleen is responsible for "the raising of the clear and descent of the turbid," which refers to its ability to help move waste materials out of the body. If this function fails, the "clear and turbid" substances can mix and sink into the lower burner and bladder.
Kidney weakness can be inherited and can increase with age. Chronic illness and excessive sexual activity can also weaken the kidneys. Kidney yang qi is particularly vulnerable to prolonged exposure to cold conditions or excessive lifting or standing. In some cases, particularly in younger people, kidney qi may be weakened while kidney yang remains intact, in which case cold symptoms may not be present.
Kidney yin can be damaged through overwork, insufficient sleep, febrile disease, dehydration, and the use of some prescription and recreational drugs.
The kidneys and bladder are closely related, so weakness in the kidneys can affect the bladder. When kidney qi is weak, not only is qi transformation impaired, but the bladder is also vulnerable to pathogenic invasion, especially by damp-heat.