False Positives & Fast Prescriptions

What You Need to Know About Urine Tests and Antibiotics

It started with a routine urine dipstick. I was completely asymptomatic—no discomfort, no urgency, no pain. And yet, the test came back positive for leukocytes and trace blood. Without hesitation, I was offered antibiotics.

And something in me said… pause.

I asked if we could run a culture instead. That came back negative. So did another round of testing. Still—no symptoms. Eventually, I was referred to a urologist, who performed a microscopic urinalysis, the gold standard.

The result? Absolutely nothing was wrong. What looked like an infection never was. It took 6 weeks to reach that conclusion. I’m sharing this because I know I’m not alone. Every day, women are offered antibiotics “just in case”—and many never learn that their test results may not actually mean what they were told. Let’s unpack how this happens—and how we can change the conversation.

What’s a Dipstick Anyway? And Why Does It Cause So Much Confusion?

Urine dipsticks are a common screening tool—quick, affordable, and easy to use in clinical settings. They test for things like:

• Leukocytes (white blood cells)

• Nitrites (byproducts of bacteria)

• Protein

• Blood

But here’s the thing: dipsticks don’t identify infection. They simply tell us something might be going on—without context.

So what causes false positives?

You’d be surprised how common they are—especially for leukocytes or trace blood in the absence of symptoms. Here are just a few reasons:

• Vaginal contamination during sample collection

• Menstruation or spotting

• Exercise-induced hematuria (blood from movement)

• Normal flora or external irritation

• Time lapse between collection and testing

• Concentrated or dilute urine

• Improper collection technique

• Expired dipsticks or improper storage of them

In my case, I wasn’t menstruating. I hadn’t exercised vigorously. I collected the sample properly. And yet… leukocytes and trace blood. So what next?

From Dipstick to Diagnosis: Why Culture and Microscopy Matter

Let’s break it down:

• Dipstick = Screening only

• Urine culture = Looks for bacterial growth

• Microscopic urinalysis = Confirms if there are actually white blood cells or bacteria present

That final test—microscopy—was the only one that gave me a definitive answer. And it took six weeks and multiple visits to get there. I’m incredibly grateful for my OB/GYN. She didn’t pressure me. She listened when I said I wasn’t comfortable starting antibiotics without more information. And she kept ordering tests to help get to the root.

In Functional Nutrition, we work from three core tenets: Therapeutic Partnership — walking with the client, not above them

Root Cause Resolution — asking why, not just what

Systems-Based Thinking — seeing how everything connects

My OB/GYN offered exactly what I needed most: a true partner in my care and a willingness to dig deeper. What wasn’t used (and this isn’t a criticism—it just wasn’t part of the standard model) was a systems-based framework. That’s the heart of what I do in my own practice: weaving together symptoms, timelines, and context to support real healing.

The Problem with “Just in Case” Antibiotics

It’s shockingly common for women to be prescribed antibiotics for asymptomatic bacteriuria (presence of bacteria without symptoms)—especially after a dipstick result.

But a 2022 study published in Patient Preference and Adherence showed that women often receive antibiotics unnecessarily, leading to avoidable side effects, resistance, and gut disruption.

Antibiotics aren’t harmless “just in case” tools. They can:

• Disrupt the gut microbiome

• Lead to diarrhea, yeast overgrowth, and histamine flares

• Contribute to antimicrobial resistance

• Cause unnecessary worry or medicalization of a non-problem

  
  

And it’s not that providers don’t care—they do. But sometimes, out of time constraints or outdated protocols, they act first and test later. This is where informed choice matters. And your voice matters too.

How to Advocate for Yourself (Without Feeling Like a Jerk)

Speaking up in a medical setting can feel intimidating—but you can do it with clarity and kindness. Here are a few ways to keep the conversation open and collaborative:

• “Can we wait for the culture results before starting treatment?”

• “I’m not having any symptoms—is it okay to monitor first?”

• “Would a microscopic analysis give us more clarity before deciding?”

You’re not second-guessing their expertise—you’re adding your lived experience to the equation. That’s what therapeutic partnership is all about.

“More Testing Must Mean Something’s Wrong,” and Other Myths

Let’s bust a few common beliefs:

Myth: If something shows up on a test, something must be wrong.

Truth: Dipstick results need context—without symptoms or further testing, they’re not diagnostic.

Myth: It’s safer to just take antibiotics right away.

Truth: Overtreatment comes with risks—waiting for confirmation may be the safer choice.

Myth: Doctors always follow up with more tests.

Truth: Sometimes they don’t—or don’t have the tools to. You can ask for what you need.

Trust Your Body. Ask the Questions.

You are the expert on how your body feels. And your voice is a valid, vital part of your care team. If you’ve ever felt brushed off, unsure, or caught in a cycle of testing without clarity—I see you. And I want to help.

Through my Discovery Sessions and Case Reviews, I help women explore their symptoms (or strange lab results) through a lens of context, connection, and clarity. Sometimes the answers are simple. Other times, it takes a little digging. But you're never alone in the process.

Your body is always sending messages—you don’t have to panic, but you can pause and listen.