Seek medical advice within 24-48 hours if you experience: Dark urine that does not lighten after increasing your fluid intake (aim for pale yellow urine, but follow any specific fluid restriction advice if you have heart or kidney disease) Urine that appears tea-coloured, cola-coloured, or brown (suggesting possible bilirubin) Persistent dark urine lasting more than 2-3 days Accompanying symptoms such as pale stools or yellowing of the skin or eyes (jaundice) Reduced urine output or difficulty passing urine Unexplained fatigue, weakness, or confusion Seek immediate medical attention (contact 999 or attend A&E) if dark urine occurs alongside: Severe, persistent abdominal pain, particularly if accompanied by vomiting (possible pancreatitisstop taking Ozempic pending medical review) Persistent vomiting preventing fluid intake Signs of severe dehydration (dizziness when standing, rapid heartbeat, very dry mouth, sunken eyes) Fever with dark urine Heavy bleeding in urine with clots or inability to pass urine NICE guidance on acute kidney injury (NG148) emphasises the importance of monitoring patients on medications that may affect renal function, particularly when combined with dehydration

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The biggest mistake I see people make is trying to force their old eating patterns onto their new physiology