extracting the urine...

[pompey boy]

is something I seem to be too good at. I drink a lot of fluids because I feel like I need to (more about that in a minute) and therefore urinate a lot. On a typical day I will drink some 6 litres of fluids (plus whatever is in the foods that I eat) and pass 3-4 litres of urine. It's as though my body is unable to retain water for its own use; it just passes through. Needless to say having to use the loo roughly once an hour is a bit of a pain and having to get up a few times a night isn't great either. Some time spent searching on-line suggests normal fluid consumption is 2-3 litres per day and normal urine volume is 0.5 to 2 litres.

I don't often feel thirsty but rather I feel dehydrated. Typical signs are neck, underarms or groin area being very warm to the touch, my face feeling flushed, general fatigue when there isn't really a good reason, a slight heaviness or aching in my legs when lying down, a higher than normal pulse, one or both ears getting very warm and red (!!) and generally feeling too warm. I drink some water (typically 250ml, maybe more) and the symptoms go away for a while. I drink mostly water and 4-5 cups of coffee during the course of the day. Alcohol consumption just exacerbates things so I minimise what I drink.

This has been going on for a few years and I finally went to my GP. First thing he did was check my blood sugar with a finger prick tester and it's spot on. Standard blood and urine tests have shown nothing wrong. He's now going to speak to a biochemist and we'll take it from there. I think at first he wondered if my thirst was all in my head but when I described what happens if I don't drink he's fairly convinced the thirst is real.

So, any thoughts as to what's going on? Has anyone has something similar?

[steveT350C]

Try cutting down on the coffee. couple of links here, you may be more sensitive to caffeine

http://www.fitday.com/fitness-articles/nutrition/h...

http://news.bbc.co.uk/1/hi/magazine/6945697.stm

[pompey boy]

I never felt as though I drink too much coffee but I suppose it's worth a try. I'm not a tea or fizzy drinks person so coffee is my only caffeine source. I did eliminate coffee from my diet for a while a few years ago and don't recall there being a change. I do like my coffee; it'll be much harder to give up than alcohol.

[steveT350C]

I rarely drink the stuff; cannot drink coffee after lunchtime, would not be able to sleep. And I see the size of takeout coffees from Costa and the like, they are about 3 x the size of what I would call a 'cup of coffee'.

Anyway, just a thought. Hope you get things sorted. Certainly worth seeing another GP for second opinion.

[The_Doc]

He's tested you for diabetes mellitus

Perhaps you have diabetes insipidus

[pompey boy]

An interim update - early days still but a 50% reduction in the coffee intake has resulted in pretty much a 50% reduction in fluid intake as well as a corresponding reduction in urine output. And more importantly, the previous signs of dehydration that I was seeing are v much reduced. I never felt my coffee/caffeine intake was that high but clearly it was enough to upset the balance. I'm also surprised that the after-effects of caffeine (last coffee usually no later than 16:00) could have an effect well into the night. Even an evening coffee has never much hindered my sleep but it would caffeine's other effects are longer lasting, at least for me.

So thanks to the suggestion of reducing coffee intake; I'm glad I didn't bet against that one!

[hidetheelephants]

This isn't really surprising, caffiene is diuretic.

[HughS47]

The_Doc said:

He's tested you for diabetes mellitus

Perhaps you have diabetes insipidus

^^^ Agreed - get your urine and serum osmolality checked

[pompey boy]

Urine osmolality was tested and came back as normal. I don't know specifically what was tested in the bold and urine samples but they were the normal tests for polydipsia (excessive thirst).

[goldblum]

Have you had a catecholamine test? Caffeine can raise plasma epinephrine levels, resulting in a number of the symptoms you describe.