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I am a 35 yr/old female. I have had terrible smelling urine…

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I am a 35 yr/old...
I am a 35 yr/old female. I have had terrible smelling urine for several weeks, and lower back pain that seems to have started around the same time. I have no other symptoms. I recently lost 25 pounds, but it was intentional and didn’t involve diet pills or supplements. I’ve had UTIs in the past (2-3 and not for years) so I know those symptoms and know my current symptoms do not resemble them at ALL. I don’t drink alcohol at all, I smoke, but just one per day. I am not dehydrated or overweight. I have had the same sexual partner for 3 years and always practice safe sex, but am not on hormonal birth control. I have been researching my symptoms for weeks now and haven’t found any answers and am not even sure what kind of doctor I would need to see. Any insights would be much appreciated!
Submitted: 7 months ago.Category: Medical
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Answered in 14 minutes by:
11/25/2017
Doctor: Dr. Mo, Board Certified MD replied 7 months ago
Dr. Mo
Dr. Mo, Board Certified MD
Category: Medical
Satisfied Customers: 2,007
Experience: Board Certified MD
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Hi, Dr. Mo here with JA. Please let me review the information and I'll reply shortly.

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Doctor: Dr. Mo, Board Certified MD replied 7 months ago

Can you describe the low back pain to me a little more?

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Customer reply replied 7 months ago
It is a dull ache, worse on the right side, and I almost exclusively notice it when standing for more than 5 minutes. Not as bad if I am walking, just when standing still.
Doctor: Dr. Mo, Board Certified MD replied 7 months ago

And if you were to bend or stretch in either direction do you feel the pain gets a little worse?

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Customer reply replied 7 months ago
No worse from bending or stretching but no better either.
Doctor: Dr. Mo, Board Certified MD replied 7 months ago

And have you noticed any fevers at all?

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Doctor: Dr. Mo, Board Certified MD replied 7 months ago

I'm guessing there is no leg weakness or numbness or anything else concerning?

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Customer reply replied 7 months ago
None recently. Prior to these symptoms I had a respiratory infection, an ear infection, and a stomach virus (24hr), one right after the other. This was end of September to mid-October. All of these things were going around at the university where I work so I wasn’t particularly concerned. I saw a doctor at the time and was on a round of antibiotics.
Customer reply replied 7 months ago
I had a fever each time, ranging from 99.0-102
Doctor: Dr. Mo, Board Certified MD replied 7 months ago

Do you feel the back pain is getting worse or staying about the same?

I don't see a connection with the smell of the urine and back back pain. Are you worried about something in particular that I can address first before I give you my impression?

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Customer reply replied 7 months ago
The back pain is about the same. The only thing that even remotely seemed possible was type 2 diabetes, but I have no family history and am not overweight so that seems fairly unlikely.
Doctor: Dr. Mo, Board Certified MD replied 7 months ago

I think the fact that your weight is good and you're otherwise healthy rules out diabetes which is a disease of those with a lot of excess weight and unhealthy lifestyles and diets.

I suspect the urine smell is just a change in the bacterial flora of the skin which react to the molecules in the urine and create the smell. The back pain seems to be muscular from what you're describing with the standing.

I can't make a more serious connection based on what you have told me.

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Customer reply replied 7 months ago
Would something like that cause such a drastic change? What causes change in bacterial flora?
Doctor: Dr. Mo, Board Certified MD replied 7 months ago

If you've been on antibiotics recently then all your skin and gut bacteria change which will change the smell of the urine. That's probably the most common cause.

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Customer reply replied 7 months ago
I have been off of the antibiotic for over a month and the smell hasn’t gotten even remotely better though. If that is the case, at what point would you say I need to call my doctor? In other words, how long is too long for the symptoms to last following the completion of antibiotic treatment?
Doctor: Dr. Mo, Board Certified MD replied 7 months ago

I would only call your doctor if the back pain doesn't improve with some targeted stretching and core and back exercises and if after trying a course of over the counter probiotics you see no improvement in the smell of the urine.

I would wait another 1 week and see how things progress. That would seem like a safe timeline in my opinion.

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Doctor: Dr. David, Board Certified Physician replied 7 months ago
Dr. David
Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 49,908
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This is Dr. Davie

have you had a recent urinalysis and urine culture

some urine bacterial infections can be resistant to certain antibiotics.

the best way to tell is to get a urine culture which can tell if bacteria is still in your urine

are you able to drink more water and urinate more frequently?

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Customer reply replied 7 months ago
I increased my water intake after the symptom appeared and have noticed no changes in frequency associated with the odor. No pain at all, and no frequent urges to go to the bathroom, both of which I experienced when I had UTIs in the past. I haven’t had a UTI in probably 10 years. I haven’t had a UA recently but it just doesn’t feel like a UTI
Doctor: Dr. David, Board Certified Physician replied 7 months ago

you could have a small kidney stone causing your lower back pain and odor in your urine

you should ask your doctor for ultrasound scans of your kidneys to check for kidney stones.

kidney stones can cause some trace blood in the urine as well seen on urinalysis.

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