Urine Blood / Haemoglobin (Dipstick)
Kidney Function marker
Urine Blood (Hb)
Urine Blood / Haemoglobin (Dipstick)
Dipstick screen that detects haemoglobin AND myoglobin via peroxidase activity, reported qualitatively (negative, trace, 1+ to 3+). A positive result can mean red cells (haematuria), free haemoglobin (haemolysis), or myoglobin (muscle breakdown). Normally negative.
PED Notes
STRONG PED relevance. The blood dipstick cannot distinguish haemoglobin from myoglobin, which is the key athlete pitfall: a positive dipstick with FEW or NO red cells on microscopy points to myoglobinuria from rhabdomyolysis or to haemolysis, not true bleeding. Heavy resistance training, very high muscle mass, severe DOMS, dehydration, and some AAS raise rhabdomyolysis risk; intense weight-bearing exercise can also cause foot-strike (march) haemolysis that releases free haemoglobin. Always cross-reference creatine kinase (markedly elevated in rhabdomyolysis) and the Urine Red Cells microscopy count. Trenbolone, high-dose orals, and NSAID use add renal stress that compounds the risk during a rhabdomyolysis episode.
When high
If Positive (trace to 3+):
- Confirm with microscopy: a positive dipstick MUST be correlated with the red cell count
- Dipstick positive WITH red cells on microscopy = true haematuria: evaluate as for Urine Red Cells (infection, stones, trauma, exercise, or, if persistent, urological work-up)
- Dipstick positive WITHOUT red cells = myoglobin or free haemoglobin: check creatine kinase urgently to assess for rhabdomyolysis
Key Context for Athletes (CRITICAL):
- Tea-coloured or cola-coloured urine with a positive blood dipstick after very heavy training, especially with muscle pain, swelling, and weakness, is rhabdomyolysis until proven otherwise: check CK, hydrate aggressively, and seek medical care promptly
- Markedly elevated CK (often more than 5x the upper limit, frequently far higher) with myoglobinuria risks acute kidney injury: do not push through it
- Foot-strike haemolysis after long runs causes transient free haemoglobin and resolves with rest and adequate footwear/cushioning
- Reduce or pause nephrotoxic compounds (trenbolone, high-dose orals, NSAIDs) during and after a rhabdomyolysis episode to protect the kidneys
When low
If Negative:
- A negative dipstick is the normal, reassuring finding
- It makes significant haematuria, haemolysis, and myoglobinuria unlikely, though a normal result does not entirely exclude intermittent or low-grade bleeding
Clinical context:
- The blood pad detects peroxidase activity, which is present in haemoglobin AND myoglobin, so the dipstick alone cannot tell bleeding from muscle breakdown: microscopy and creatine kinase resolve the ambiguity
- A positive dipstick with no red cells on microscopy is the classic clue to myoglobinuria (rhabdomyolysis) or intravascular haemolysis
- In athletes the combination of training history, urine colour, CK level, and microscopy guides the interpretation far more than the dipstick in isolation
History Chart
Reading History
Frequently Asked Questions
Reference Ranges
Standard Range
VitalMetrics Range