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What Causes Bitter Tasting Saliva When Suffering From Polydipsia?
Question: I have polydipsia and drink 4-6 litres of water a day. Over the past 18 months I have been checked and cleared of GERD, diabetes, diabetes insipidus, kidney malfunction, heart disease (CT scan), lungs CT scan revealed benign adenoma and diaphragm hernia. I have also had a gastro-intestinal endoscopy which did not detect any problem.
If I am dehydrated I have the following symptoms
1. very bitter taste saliva when I wake up in the morning
2. severe cramp on the hamstring and feet sometimes muscle twitching on the side of palms
3. pain around my waist
4. dizziness when I stand
5.sleepiness while seated
6. itching at first,then pain in my right chest cavity --between the breast & shoulder
All these symptoms disappear in less than an hour once I re-hydrate--when my urine is clear like water. I have to drink 3 litres of water before 1100am in order to function at work ,otherwise I just fall into sleep. I will then drink more water in the afternoon and into the night, right up to bedtime.
I am in mid 50s , 166cm tall and weigh 86kg. I have stopped drinking alcohol because it makes my situation worse.I have suffered polydipsia since 2004 but was taking about 2 litres of water per day at first but the situation has worsened over the years, especially pain in the waist.
If I am dehydrated I have the following symptoms
1. very bitter taste saliva when I wake up in the morning
2. severe cramp on the hamstring and feet sometimes muscle twitching on the side of palms
3. pain around my waist
4. dizziness when I stand
5.sleepiness while seated
6. itching at first,then pain in my right chest cavity --between the breast & shoulder
All these symptoms disappear in less than an hour once I re-hydrate--when my urine is clear like water. I have to drink 3 litres of water before 1100am in order to function at work ,otherwise I just fall into sleep. I will then drink more water in the afternoon and into the night, right up to bedtime.
I am in mid 50s , 166cm tall and weigh 86kg. I have stopped drinking alcohol because it makes my situation worse.I have suffered polydipsia since 2004 but was taking about 2 litres of water per day at first but the situation has worsened over the years, especially pain in the waist.
Brief Answer:
Tell me more about this problem.
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about this polydypsia and the difficulties that you have had getting treated. There are a few questions I will like you to address before we move on.
1. How often do you urinate?
2. On what basis was diabetes insipidus excluded?
I love addressing every problem from basic reasoning. If you drink too much, then you must get rid of this excess water. How do you thin it leaves the body? Is it through excessive sweating or excessive urination.
If it is excessive urination, then there must be a problem with water retention. The kidneys would fail to retain enough water should there be a problem with its hormonal system like in diabetes insipidus or there is an osmotically active substance in the lumen that is preventing this fro going on.
If the excess fluid intake leaves the body through excessive sweating, then the system that controls this needs to be closely evaluated. For now, give me answers to the above questions so that we can reason together in an attempt to resolve this mystery.
Hope to hear from you. I wish you well.
Dr. Ditah, MD.
Tell me more about this problem.
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about this polydypsia and the difficulties that you have had getting treated. There are a few questions I will like you to address before we move on.
1. How often do you urinate?
2. On what basis was diabetes insipidus excluded?
I love addressing every problem from basic reasoning. If you drink too much, then you must get rid of this excess water. How do you thin it leaves the body? Is it through excessive sweating or excessive urination.
If it is excessive urination, then there must be a problem with water retention. The kidneys would fail to retain enough water should there be a problem with its hormonal system like in diabetes insipidus or there is an osmotically active substance in the lumen that is preventing this fro going on.
If the excess fluid intake leaves the body through excessive sweating, then the system that controls this needs to be closely evaluated. For now, give me answers to the above questions so that we can reason together in an attempt to resolve this mystery.
Hope to hear from you. I wish you well.
Dr. Ditah, MD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. Once I drink water I urinate every 30 minutes or so after drinking water, but I sometimes have to force myself to retain a full bladder when I am attending meetings or when it is not convenient. If I do not drink a lot of water my urinating is normal but then I will be feeling dizzy etc., and also have a tangy sensation in my eyes, like I have dropped some lemon juice in them.
2.Diabetes insipidus was excluded on the basis of two separate blood and urine tests. But I did not get a water deprivation test.
One doctor said if drinking water solves the problem then I should just continue, but another from the same medical clinic said 4+ litres of water per day was excessive. It was another doctor from a different hospital who suggested I also research the problem on the Internet, hence my seeking your expertise.
The effect of not taking 4+ litres a day are cumulative.If I don't I will have to make up for it by drinking a lot more after a two to for days.
2.Diabetes insipidus was excluded on the basis of two separate blood and urine tests. But I did not get a water deprivation test.
One doctor said if drinking water solves the problem then I should just continue, but another from the same medical clinic said 4+ litres of water per day was excessive. It was another doctor from a different hospital who suggested I also research the problem on the Internet, hence my seeking your expertise.
The effect of not taking 4+ litres a day are cumulative.If I don't I will have to make up for it by drinking a lot more after a two to for days.
Brief Answer:
Please, as much as you drink...so you urinate!
Detailed Answer:
Hi and thanks for following up with me.
If your urination is normal should you not drink much water, then this is clearly not diabetes insipidus. Though you didn't do a water deprivation test, when you don't drink much water because of some reasons, you urinate normally and this serves as a water deprivation test for me.
I am concerned that you have what is termed psychogenic or primary polydipsia. Taking a critical look at your symptoms, they are not strictly symptoms of dehydration. They are more suggestive of electrolytes imbalance and this can be caused by the excessive fluids intake. We may be leaning more towards a psychological problem than an organ dysfunction.
http://nationalnursingreview.com/2010/10/potomania-or-excessive-water-consumption/
http://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/basics/causes/con-0000?p=1
I will like you to read through the above pages and come back to me with more questions. After that, we would establish a plan and follow through to see where this leads us.
Waiting to hear from you!
Dr. Ditah, MD.
Please, as much as you drink...so you urinate!
Detailed Answer:
Hi and thanks for following up with me.
If your urination is normal should you not drink much water, then this is clearly not diabetes insipidus. Though you didn't do a water deprivation test, when you don't drink much water because of some reasons, you urinate normally and this serves as a water deprivation test for me.
I am concerned that you have what is termed psychogenic or primary polydipsia. Taking a critical look at your symptoms, they are not strictly symptoms of dehydration. They are more suggestive of electrolytes imbalance and this can be caused by the excessive fluids intake. We may be leaning more towards a psychological problem than an organ dysfunction.
http://nationalnursingreview.com/2010/10/potomania-or-excessive-water-consumption/
http://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/basics/causes/con-0000?p=1
I will like you to read through the above pages and come back to me with more questions. After that, we would establish a plan and follow through to see where this leads us.
Waiting to hear from you!
Dr. Ditah, MD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1.Psychogenic polydipsia is so called because it arises from the human mind, but my water intake is to cure the symptoms that I stated in my first message.For example right now I am feeling the pain in my chest cavity because of dehydration but the pain will go away once I sufficiently re-hydrate. Could they be a result of electrolyte imbalance?
2.Is it possible to seek to locate the source of the problem outside the known areas of psychogenic polydipsia, diabetes insipidus etc.,
3 The doctors I am seeing also think it is psychogenic polydipsia but they cannot explain why I have pain in the waist-- it is quite severe--blurred vision, sleepiness , chest pain, muscle cramp, and feel like the ground is moving under my feet when I am standing, itching in the urinary track etc. All these symptoms disappear once I rehydrate.
4. I am just thinking perhaps liver/gall bladder/bile complications.I once suffered a bout of jaundice in 1980.
5. Blood test indicated high AST and ALT. AST is 41 -Ref.range 10--35; ALT 78 -ref.range 5--40. An improvement from the days I used to drink.
6. Or could it be a rare form of cancer ? My chest pain date back to more than two decades but I always thought it was caused by smoking which I quit in 2007.
Thank you Dr. Ditah.
2.Is it possible to seek to locate the source of the problem outside the known areas of psychogenic polydipsia, diabetes insipidus etc.,
3 The doctors I am seeing also think it is psychogenic polydipsia but they cannot explain why I have pain in the waist-- it is quite severe--blurred vision, sleepiness , chest pain, muscle cramp, and feel like the ground is moving under my feet when I am standing, itching in the urinary track etc. All these symptoms disappear once I rehydrate.
4. I am just thinking perhaps liver/gall bladder/bile complications.I once suffered a bout of jaundice in 1980.
5. Blood test indicated high AST and ALT. AST is 41 -Ref.range 10--35; ALT 78 -ref.range 5--40. An improvement from the days I used to drink.
6. Or could it be a rare form of cancer ? My chest pain date back to more than two decades but I always thought it was caused by smoking which I quit in 2007.
Thank you Dr. Ditah.
Brief Answer:
This is psychogenic polydipsia!
Detailed Answer:
Hi and thank you so much for this follow up information.
I still maintain your diagnosis of psychogenic polydipsia. The mind has been conditioned to report all of these symptoms once it is conscious of the fact that you have not taken sufficient fluids in a day. Look at how diverse your symptoms are and cannot be explained by a single disease process. These symptoms would closely fit the diagnosis of somatoform disorder. This is another psychiatric condition and it is not rare to have another psychiatric condition once you already have one.
If these symptoms had and organic cause, why have they not been able to get a definite diagnosis? If I were your doctor, I would slowly wean you off this excess water while closely monitoring your body vital functions like the heart, blood pressure, respiration, etc to see if any of these would show something of concern.
I hope this helps. Tell me what you think. Gall bladder, liver disease. etc cannot explain these symptoms with a magical pill being water. NO.
I wish you well.
Dr. Ditah,MD.
This is psychogenic polydipsia!
Detailed Answer:
Hi and thank you so much for this follow up information.
I still maintain your diagnosis of psychogenic polydipsia. The mind has been conditioned to report all of these symptoms once it is conscious of the fact that you have not taken sufficient fluids in a day. Look at how diverse your symptoms are and cannot be explained by a single disease process. These symptoms would closely fit the diagnosis of somatoform disorder. This is another psychiatric condition and it is not rare to have another psychiatric condition once you already have one.
If these symptoms had and organic cause, why have they not been able to get a definite diagnosis? If I were your doctor, I would slowly wean you off this excess water while closely monitoring your body vital functions like the heart, blood pressure, respiration, etc to see if any of these would show something of concern.
I hope this helps. Tell me what you think. Gall bladder, liver disease. etc cannot explain these symptoms with a magical pill being water. NO.
I wish you well.
Dr. Ditah,MD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much Doctor.
Your explanation makes much sense to me. But so was the other Doctor who said if my body needs a minimum of 4 litres a day then I should simply drink it-- quite logical too. He went on to say some people go through their day with half a litre, some with one litre, others with two ,three, four five litres and so on.
Is there an established amount one should drink a day , or it depends on body weight, diet , climatic conditions etc?
Where, then, do you draw the line between hydration resulting from psychiatric condition as you say mine could be , or a mere physiological need for four litres of water ?
Again, how do I get weaned off water ? Does it require medication ? I have tried to wean myself off so many times only to experience the symptoms I have described.
Cramp and dizziness are the most problematic. Is it possible to take medication for them as I reduce water consumption ?
I hope I can just snap out of this water regimen and be normal again.
Thank you once more.
Your explanation makes much sense to me. But so was the other Doctor who said if my body needs a minimum of 4 litres a day then I should simply drink it-- quite logical too. He went on to say some people go through their day with half a litre, some with one litre, others with two ,three, four five litres and so on.
Is there an established amount one should drink a day , or it depends on body weight, diet , climatic conditions etc?
Where, then, do you draw the line between hydration resulting from psychiatric condition as you say mine could be , or a mere physiological need for four litres of water ?
Again, how do I get weaned off water ? Does it require medication ? I have tried to wean myself off so many times only to experience the symptoms I have described.
Cramp and dizziness are the most problematic. Is it possible to take medication for them as I reduce water consumption ?
I hope I can just snap out of this water regimen and be normal again.
Thank you once more.
Brief Answer:
The body keeps as much water as it needs!
Detailed Answer:
Hi and thank you so much for keeping the discussion alive.
The body wouldn't request for 4liters and send out as much as you take in. It is simply not possible and clearly goes against the working mechanism of the human system.
Averagely, we need about 1.5-2Liters of fluid daily. Variations may be based on various environmental conditions. However, it is not urine that would be increased in these cases because other losses like sweating would account for this. Also, urine would be in small volumes, highly concentrated and yellowish as opposed to what you described. Your description of repeated urination, clear as water, etc clearly fits the description of the body working hard to clear off excess water that it doesn't need.
The solution is you and in you. I will not succumb to this unnecessary water intake. I may feel uneasy with the symptoms but none will kill me. I will walk through the hard way because it is the only way out. You have to talk and act yourself out of it. If you need someone to help you through the process, involve your friends, colleagues, family, etc.
Cramp and dizziness would not kill you. Give it a try and resist the temptation of simply taking more water....Record your symptoms and the intensity over time and send to me. You would realize that the first hours/days are difficult but thereafter, it would slowly get better.
Asking you to drink as much as you desire is an easy way out. And of course, you can testify that it is simply not the right solution. It keeps you away from facing the real challenge of reversing your water "addiction".
Happy to keep the exchanges going on!
Dr. Ditah, MD.
Dr. Ditah, MD
The body keeps as much water as it needs!
Detailed Answer:
Hi and thank you so much for keeping the discussion alive.
The body wouldn't request for 4liters and send out as much as you take in. It is simply not possible and clearly goes against the working mechanism of the human system.
Averagely, we need about 1.5-2Liters of fluid daily. Variations may be based on various environmental conditions. However, it is not urine that would be increased in these cases because other losses like sweating would account for this. Also, urine would be in small volumes, highly concentrated and yellowish as opposed to what you described. Your description of repeated urination, clear as water, etc clearly fits the description of the body working hard to clear off excess water that it doesn't need.
The solution is you and in you. I will not succumb to this unnecessary water intake. I may feel uneasy with the symptoms but none will kill me. I will walk through the hard way because it is the only way out. You have to talk and act yourself out of it. If you need someone to help you through the process, involve your friends, colleagues, family, etc.
Cramp and dizziness would not kill you. Give it a try and resist the temptation of simply taking more water....Record your symptoms and the intensity over time and send to me. You would realize that the first hours/days are difficult but thereafter, it would slowly get better.
Asking you to drink as much as you desire is an easy way out. And of course, you can testify that it is simply not the right solution. It keeps you away from facing the real challenge of reversing your water "addiction".
Happy to keep the exchanges going on!
Dr. Ditah, MD.
Dr. Ditah, MD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If it is psychogenic polydipsia and marijuana is getting acceptance in pharmacology can I just try it ? It could possibly pep me up a bit and aid my withdrawal, my residue of moral upbringing notwithstanding.
I will evaluate my life to see if there is something there I need to re-organize; perhaps diet, meal times and amount of sleep and sure keep a record as you advise
Yes, cramp and dizziness may not kill but they totally ground me; the cramp that I suffer can be very painful and I need to lean against something once dizziness sets in. How do I manage this ?
Thank you once again for the advise.
I will evaluate my life to see if there is something there I need to re-organize; perhaps diet, meal times and amount of sleep and sure keep a record as you advise
Yes, cramp and dizziness may not kill but they totally ground me; the cramp that I suffer can be very painful and I need to lean against something once dizziness sets in. How do I manage this ?
Thank you once again for the advise.
Brief Answer:
See below.
Detailed Answer:
I don't have any concrete information that talks about marijuana use in clients with psychogenic polydipsia and cannot therefore comment on this. If you have more information on this, please kindly send the link to me so that I can review and comment on.
I know these withdrawal symptoms especially the dizziness and cramps are tough. I will like you to start all these measures when you are not on duty and most probably over the weekends/days off so that you would not have the pressure of having to deal with both these and work. Beside, you are sick and your doctors could consider giving you some time off to start this process and get the symptoms to tolerable levels before you return to work.
Please, consider talking with a psychiatrist as well to help guide and encourage through this process.
I hope this helps. I wish you well and come for more information as need arises.
Dr. Ditah, MD.
See below.
Detailed Answer:
I don't have any concrete information that talks about marijuana use in clients with psychogenic polydipsia and cannot therefore comment on this. If you have more information on this, please kindly send the link to me so that I can review and comment on.
I know these withdrawal symptoms especially the dizziness and cramps are tough. I will like you to start all these measures when you are not on duty and most probably over the weekends/days off so that you would not have the pressure of having to deal with both these and work. Beside, you are sick and your doctors could consider giving you some time off to start this process and get the symptoms to tolerable levels before you return to work.
Please, consider talking with a psychiatrist as well to help guide and encourage through this process.
I hope this helps. I wish you well and come for more information as need arises.
Dr. Ditah, MD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
There is no concrete information that is readily available on medicinal use of marijuana but I thought you might know from your professional journals. Anyway I do not have the guts to indulge it.
I started reducing water intake yesterday and so far I have not had any of the symptoms I described but is still too early to tell how long it is going to hold.My biggest fear is that the cramp could happen while driving to work.
I have two days off work and could add an extra day.
The knowledge that I am not sick is going to help me recover and will have to XXXXXXX all my strength.
I will update you on the progress.
Thank you very much for your professional advice.
I started reducing water intake yesterday and so far I have not had any of the symptoms I described but is still too early to tell how long it is going to hold.My biggest fear is that the cramp could happen while driving to work.
I have two days off work and could add an extra day.
The knowledge that I am not sick is going to help me recover and will have to XXXXXXX all my strength.
I will update you on the progress.
Thank you very much for your professional advice.
Brief Answer:
Thank you for your words!
Detailed Answer:
Hi and thank you for your kind words. They are humbling and motivating.
Please, be gentle with the water reduction. Do not drop immediately to the normal volumes I mentioned in our discussions. Make it a gradual weaning off process over weeks to months so as not to overwhelm the system. This will also limit the intensity of the withdrawal symptoms.
Congratulation on taking the bold step. Keep me updated. You will never walk alone as long as you seek my input!
Dr. Ditah, MD.
Thank you for your words!
Detailed Answer:
Hi and thank you for your kind words. They are humbling and motivating.
Please, be gentle with the water reduction. Do not drop immediately to the normal volumes I mentioned in our discussions. Make it a gradual weaning off process over weeks to months so as not to overwhelm the system. This will also limit the intensity of the withdrawal symptoms.
Congratulation on taking the bold step. Keep me updated. You will never walk alone as long as you seek my input!
Dr. Ditah, MD.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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