What Is Alkaptonuria? The Rare Disease That Turns Your Pee Black – Here’s Why

Updated Feb 7, 2025 | 08:00 AM IST

SummaryAlkaptonuria is a rare genetic disorder that causes black urine due to homogentisic acid buildup, leading to joint pain, cartilage damage, and skin discoloration. It has no cure but can be managed.
What Is Alkaptonuria? The Rare Disease That Turns Your Pee Black – Here’s Why

Image Credit: Canva

A condition, known commonly as "black urine disease" or Alkaptonuria is a rare genetic disorder involving protein metabolism, and it has its root in the mutation of the homogentisate 1,2-dioxygenase gene, which in turn causes homogentisic acid accumulation in the body. The appearance of dark urine after exposure to air is due to this kind of accumulation; however, a variety of symptoms can be expected, such as joint stiffness, changes in pigmentation, and other long-term health complications. Although the prevalence has been estimated to be between 1 in 250,000 and 1 in 1 million people in the United States, its effects are indeed high on those affected.

Alkaptonuria is an autosomal recessive disease, meaning that the child must inherit a defective copy of the HGD gene from both parents. If both parents are carriers, their offspring have a 25% chance of inheriting two faulty genes and developing alkaptonuria. The condition is genetic but is often not diagnosed for years because it progresses slowly and its early symptoms appear to be harmless.

Symptoms of Alkaptonuria

The most characteristic and common initial symptom of alkaptonuria is dark urine. The reason for this is due to the fact that excess HGA is excreted in the urine and upon oxidation in the presence of air, it gives the urine a brown or black color. Though it is often considered cosmetic, the long-term accumulation of HGA within the connective tissues produces more complicated health problems.

Progressive joint pain and stiffness: The accumulation of HGA in cartilage leads to early-onset osteoarthritis, making movement increasingly difficult over time.

Skin and eye pigmentation changes: Affected individuals may develop bluish or grayish discoloration of the sclera (white part of the eye) and the skin, particularly in areas exposed to friction.

Cardiovascular and respiratory problems: With age, HGA accumulation can lead to valve calcifications in the heart and stiffening of connective tissues in the respiratory tract, which can cause problems in middle and old age.

Decreased mobility and spinal problems: The spine may become stiff and painful due to chronic cartilage degeneration.

These symptoms usually begin to manifest during adulthood, leading to severe complications in a person's 40s or 50s and significantly affecting the quality of their life.

How is Alkaptonuria Diagnosed?

Because of its rarity, alkaptonuria is often mistaken or overlooked early in life. However, there are several ways to confirm the condition:

Urine Testing: The gold standard in the diagnosis is the testing of urine samples for high levels of homogentisic acid via gas chromatography. In case of oxidation, which changes the color of urine to black, it is indicative of alkaptonuria.

Genetic Testing: Confirmatory genetic testing reveals mutations of the HGD gene to diagnose the condition conclusively.

Blood Tests: High levels of HGA in the blood can be used as further evidence.

Imaging Studies: X-rays and MRIs will expose cartilage and joint damage characteristic of alkaptonuria.

Management of Alkaptonuria: Is There A Cure?

At present, there is no cure for alkaptonuria; however, various treatment approaches can reduce its symptoms and slow the disease's progress:

Nitisinone Therapy: Nitisinone is a drug that inhibits the production of HGA. It has been shown to reduce HGA levels and slow tissue damage. However, it needs to be taken under close medical supervision because of potential side effects.

Low-Protein Diet: Since HGA is a byproduct of protein metabolism, reducing protein intake—especially foods rich in tyrosine and phenylalanine—may help decrease HGA production.

Pain Management: OTC pain relievers and anti-inflammatory medications can be used to relieve joint pain and stiffness.

Physical Therapy: Exercise regularly, as it may improve mobility and strengthen muscles, thus reducing strain on affected joints.

Surgical Interventions: Most people with alkaptonuria develop severe osteoarthritis necessitating joint replacement in their old age. Also, some may require heart valve replacement surgery if cardiovascular complications develop.

Life with Alkaptonuria

Although alkaptonuria is not fatal, it severely affects the quality of life. The progressive deterioration of the joints and associated symptoms can make everyday activities difficult, requiring lifestyle changes and medical interventions. The disease may cause premature aging of the joints, requiring walking aids and mobility assistance earlier than expected.

Ongoing research will continue to work on improving the treatment options by focusing on gene therapy and alternative enzyme replacement therapies. However, because of its rarity, the clinical trials and research remain sparse.

As genetic research advances, more hope for better management and possible curative approaches for alkaptonuria exists. Scientists are searching extensively for enzyme replacement therapies and innovative drugs that can target the root cause of the disorder. Being aware and being diagnosed early helps individuals better their condition and ultimately have better long-term health outcomes.

Alkaptonuria is a striking example of how one gene mutation can have widespread effects on the body. Though still a rare and often misunderstood condition, growing awareness and advances in treatment are paving the way for better care. If you or a loved one suspect symptoms of alkaptonuria, it is essential to seek early diagnosis and medical guidance to manage the disease effectively and preserve quality of life.

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Just One Psilocybin Use May Lead to Lasting Positive Brain Changes, Study Finds

Updated May 6, 2026 | 07:00 PM IST

Summary​The study participants noted that they had experienced more psychological insight after taking the 25 mg of psilocybin than they had after the 1 mg placebo, and noted "feeling optimistic about the future".
Just One Psilocybin Use May Lead to Lasting Positive Brain Changes, Study Finds

Credit: AI generated image

Psilocybin is the active ingredient found in magic mushrooms, and a new study shows that just one high dose (25 mg) is enough to cause alterations in the brain’s structures and help improve mental health.

The changes could explain why some people report psychological benefits from the experience, revealed the study published in the journal Nature Communications. The study found that the effect may last for up to a month after the experience.

In the study, researchers from the University of California, San Francisco, and Imperial College London argue that the effect may lead to “subsequent improvements in mental health”.

"Psychedelic means 'psyche-revealing,' or making the psyche visible," said senior author Robin Carhart-Harris, Professor of Neurology at UCSF.

"Our data shows that such experiences of psychological insight relate to an entropic quality of brain activity and how both are involved in causing subsequent improvements in mental health. It suggests that the trip—and its correlates in the brain—is a key component of how psychedelic therapy works," Carhart-Harris added.

How A Psychedelic Trip Improved Brain Health

Psilocybin has been the subject of several studies in people that have found it appears to alleviate symptoms of depression and anxiety. It has also shown promise in addiction medicine.

In the latest study on 28 people, none had a diagnosed mental health condition. The team gave the participants a 1 mg dose of psilocybin, which the researchers regarded as a placebo, and then monitored them with electroencephalography (EEG), which records brain activity from electrodes on the scalp.

One month after the placebo, the subjects were given 25 mg of psilocybin, a dose capable of eliciting a strong psychedelic trip.

After each experiment, the researchers measured the participants’ psychological insight, well-being, and cognitive ability. They also examined brain activity with functional MRI (fMRI) and brain connectivity with diffusion tensor imaging (DTI).

The results showed that within 60 minutes of taking the 25 mg dose of psilocybin, the EEG revealed higher entropy — which means that the brain was processing a richer body of information under the psychedelic.

A month later, the researchers looked at their subjects' brains with DTI, which measures the diffusion of water along neural tracts in the brain, and found that they were denser and had more integrity. This is the opposite of what happens in aging, which makes these tracts more diffuse.

Also Read: Ibogaine: Why Donald Trump Is Pushing US FDA To Fast-track This Psychedelic

While the result is a never-before-seen sign of how psychedelics can change the brain, the researchers cautioned that more work needs to be done to better understand the meaning of this change.

The participants noted that they had experienced more psychological insight after taking the 25 mg of psilocybin than they had after the 1 mg placebo, and noted "feeling optimistic about the future".

A month after the study, they also did better on a test of cognitive flexibility.

"Psilocybin seems to loosen up stereotyped patterns of brain activity and give people the ability to revise entrenched patterns of thought," said Taylor Lyons, a research associate at Imperial College London and the first author of the paper. "The fact that these changes track with insight and improved well-being is especially exciting."

The findings could improve treatment for people with mental illness with psilocybin, for example, by ensuring that the right dosage is used to produce the right amount of brain entropy to promote insight.

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Untreated Eczema Could Lead To Chronic Asthma: Dermatologist Answers FAQs

Updated May 5, 2026 | 10:00 PM IST

SummaryEczema is a skin disorder, but how it contributes to asthma risk is relatively unknown.
Eczema

Uncontrolled eczema can also make sleep disorders worse. (Photo credit: AI generated)

Every year on May 5, World Asthma Day is observed, an event that aims at spreading awareness about the respiratory disorders. While asthma is becoming a common occurrence in India, citing excessive pollution and unhealthy lifestyle choices. But in a shocking revelation on the occasion, Dr. Gitika Sanodia, Consultant Dermatologist at Dr L H Hiranandani Hospital, Powai, revealed that leaving eczema untreated could lead to chronic asthma. Talking about it, Dr Sanodia answered some common FAQs about eczema and asthma.

Can untreated eczema cause asthma?

Yes, especially for those suffering from early childhood onset of moderate/severe atopic dermatitis. Eczema is not always limited to being solely a skin condition. In many cases, patients who suffer from eczema actually have one part of the atopic triad, which means the patient's skin barrier is dysfunctional, allowing for allergens to enter and sensitize the immune system. With time, the same tendency can impact other organs, causing allergic rhinitis or asthma. However, it must be noted that not all children with eczema develop asthma.

Why does everybody treat eczema as merely a skin problem?

Because of symptoms including itching, dryness, redness, scaling, and oozing from the skin. The families take care to control the acute phase of eczema while ignoring the patient's predisposition to allergies. Furthermore, atopic dermatitis is an inflammatory skin condition that is accompanied by impaired skin barrier function, immune dysfunction, and environmental factors. Moreover, according to DermNet, atopy is a term used for conditions where eczema, rhinitis, and asthma happen together.

Early signs for which parents and adults should be vigilant

Parents should worry if their children with eczema exhibit recurrent coughs, wheezing, noisy breathing, difficulties breathing during playtime, nighttime coughing, chest tightness, frequent sneezing, nasal blockage, allergic rhinitis, or exacerbation of symptoms following exposure to dust, animal dander, pollens, airborne particles, or fluctuating environmental conditions.

Is eczema therapy sufficient to prevent the development of asthma?

Successful treatment of eczema can help minimize the chances of allergens penetrating the skin barrier and allergic inflammation. Nonetheless, it would not be accurate to predict with certainty that eczema therapy will effectively prevent the onset of asthma. Literature recommends the prompt restoration of the skin barrier function, regular application of moisturizing agents, avoiding triggers such as fragrances and harsh soaps, managing flare-ups with prescription corticosteroid creams, controlling infections, and referring patients with severe eczema cases.

Is it a significant public health concern?

Yes. This condition is becoming more common, especially among children. If not controlled effectively, eczema will result in poor sleeping habits, difficulties with academic performance, reduced quality of life, greater susceptibility to infections, and potentially even links to other allergies. People lack sufficient information regarding the condition because they normally medicate themselves by applying whatever ointment or steroid to their skin.

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Is Your Home Making Your Asthma Worse? Doctors Highlight Indoor Triggers

Updated May 6, 2026 | 03:58 PM IST

SummaryFrom bedding to pets to scented candles and furry friends, asthma triggers can be found indoors. Doctors urged patients to identify their personal triggers and act early, because managing their indoor environment is just as critical as managing their medication.
Is Your Home Making Your Asthma Worse? Doctors Highlight Indoor Triggers

Credit: AI generated image

Asthma is often thought of as an "outdoor" problem, with triggers such as smog, pollen, or car exhaust. But for many, the real danger may be sitting right there on the sofa or hiding under the sink.

The chronic condition affects over 260 million people. It is also responsible for over 450,000 deaths each year worldwide.

If you're doing everything right with your inhaler but still feel that tightness in your chest, it’s time to look at silent indoor triggers.

1. The Bedding "Dynasty"

“It’s a bit unsettling, but your mattress is likely home to millions of microscopic dust mites. They love the warmth and humidity of a bed. You won't see them, but you’ll feel them,” Dr. Sandeep Nayar, Principal Director & HOD - Chest & Respiratory Diseases, BLK Max Super Speciality Hospital, told HealthandMe.

The Fix: Don’t just wash your sheets; use hot water (60°C). If you haven't encased your pillows in allergen-proof covers yet, make that your priority this weekend.

2. Moisture is the Enemy

Dr Nayar said mold isn't always a giant green patch. It hides in the "sweat" behind your wallpaper or the damp corners of a bathroom that doesn't vent well. If a room smells even slightly musty, mold spores are likely in the air.

The Tip: Keep your home's humidity below 50 per cent. A simple dehumidifier can sometimes do more for your lungs than an extra dose of medicine.

3. It’s Not Just the Fur

Many people think "hypoallergenic" pets are the cure. It’s actually a protein in pet saliva and skin flakes (dander) that causes the flare-up.

The Reality: Even if you keep the dog off the bed, dander travels on your clothes. HEPA air purifiers are a must-have if you share your home with a furry friend.

4. The "Clean" Smell Myth

That "fresh lemon" scent or your favorite scented candle? Those are Volatile Organic Compounds (VOCs). To a sensitive lung, those chemicals are irritants, not cleaners.

The Switch: Move toward fragrance-free products. If a cleaning spray makes you cough, your body is telling you everything you need to know.

5. Urban Uninvited Guests

In cities, cockroach droppings are a massive, often ignored asthma trigger. Their proteins mix with household dust and get kicked up every time you walk across the floor.

The Strategy: Seal the cracks in your walls and keep the kitchen bone-dry.

Other asthma triggers include dust mites, pet dander, indoor smoke, and strong cleaning agents that can worsen symptoms over time

How To Prevent Indoor Asthma Triggers

Dr. Manisha Mendiratta, Director & Head - Pulmonology, Sarvodaya Hospital, Faridabad, told HealthandMe that the key is prevention through simple, consistent habits. To make a meaningful difference, the expert urged people to

  • ensure good ventilation,
  • reduce indoor humidity,
  • clean soft furnishings regularly,
  • avoid aerosol-based products.
  • ise air purifiers,
  • keep windows open when possible,
  • creating a smoke-free space.
“Managing asthma is about more than just a prescription. It’s about making your home a place where your lungs can finally relax,” Dr Nayar said.

“Most importantly, patients should identify their personal triggers and act early, because managing their indoor environment is just as critical as managing their medication,” added Dr. Mendiratta.

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