Urine is like a mirror for the kidneys; its condition often reflects whether the kidney function is normal. In Traditional Chinese Medicine theory, the kidneys govern body fluids and are responsible for the distribution and excretion of water in the body. Therefore, many problems related to urine are actually related to the functional state of the kidneys.

If you always feel the urge to urinate, with large amounts of pale urine resembling clear water, this may be indicative of insufficient kidney yang. Kidney yang possesses warming and transformation functions, enabling the evaporation and distribution of body fluids, as well as their reuse. If kidney yang is deficient, the proper transformation of body fluids cannot occur, and they are instead directly excreted from the body. This results in excessive urination, clear urine, and may also be accompanied by feelings of cold and lethargy.

Another situation is frequent urination, but with small amounts of urine each time, a yellow or deep yellow color, and a thick texture. This is often related to kidney yin deficiency. Kidney yin is responsible for moisturizing and controlling internal heat. Insufficient yin fluid leads to excessive virtual fire, which "roasts" the water, causing concentrated urine. Therefore, the volume is small and the color is deep, and the person may also experience dry mouth, restlessness, or sleep disturbances.

Another common issue is the inability to hold urine, where a cough or hearty laugh might cause slight leakage. In men, this may be accompanied by involuntary emission or spermatorrhea. This is often related to kidney qi deficiency. Kidney qi has a consolidating and securing function; it controls the opening and closing of the bladder and maintains the stability of the "semen gate." When kidney qi is deficient, this consolidating ability declines, leading to a loss of control over urine or semen. Individuals often also experience fatigue and low energy..

If the urine color is dark and reddish, with a burning or stinging sensation during urination, it may indicate a deficiency of both Yin and Yang in the kidneys. Long-term kidney deficiency without proper nourishment can lead to Yin damaging Yang or Yang damaging Yin, resulting in overall functional decline. Yin deficiency generates internal heat, causing yellow and painful urine; Yang deficiency impairs Qi transformation, leading to fatigue and aversion to cold. In such cases, the condition is often complex.

I once treated a middle-aged male patient in his fifties who felt an urgent need to urinate whenever he had the urge, frequently waking up 2-3 times at night, and experienced lower back and leg weakness even with slight physical activity. Based on syndrome differentiation, it was determined to be due to insufficient kidney qi and essence. Medications such as Alisma and Chinese Locust were used to tonify the kidneys and astringe urine, and it was recommended to practice kegel exercises. After two weeks, there was significant improvement in urinary frequency and nocturia.

Of course, abnormal urination may also be related to the bladder, damp-heat, or other internal organs. If the problem persists, it is best to consult a professional physician for a comprehensive assessment combining tongue and pulse diagnosis, as well as overall constitution, to provide targeted regulation. It is not advisable to use medication blindly.