Excess Thirst (Polydipsia)

There are two main symptoms of polydipsia:

• Excessive thirst
• Frequent urination (more than five litres of urine within 24 hours)

If the following symptoms accompany polydipsia, together, they may be an indication of diabetes:

• Lethargy
• Weight loss
• Slower healing of sores and wounds
• Excessive hunger
• Tingling sensation in the extremities - like fingers and toes

Read more: Gestational diabetes: symptoms, causes, diagnosis, treatment

Polydipsia is a symptom which could indicate any of these underlying diseases. Conversely, these diseases are also the cause of excessive thirst:

• Diabetes mellitus: Diabetes mellitus is a state of increased sugar levels in the blood because the insulin made by the pancreas is not absorbed by the body. Insulin helps in maintaining the levels of sugar (glucose) in the blood by eating up the extra sugar.
  A person suffering from diabetes mellitus urinates frequently (polyuria) which makes them thirsty all the time. Also, increased levels of sugar in the blood makes people thirsty, no matter how much water they have already had.
• Diabetes insipidus: Diabetes insipidus is a rare disorder where the kidneys start passing an abnormal amount of urine. Usually, people pass one or two quarts of urine a day. People with diabetes insipidus pass 3-20 quarts of urine a day. Thus, they feel thirsty all the time. A quart is one-fourth of a gallon and a gallon is 3.785 litres.
• Dehydration: In dehydration, the loss of fluids from the body is more than the intake of fluids. During summers and even during winters, the need for water in the body increases. To compensate for the state of dehydration, there is a constant urge to drink water.
• Loss of body fluids: Whenever there is a loss of body fluids, the body demands water and so the person feels thirsty all the time. There are various reasons for the loss of body fluids, such as:
  • Diarrhoea
  • Vomiting
  • Severe bleeding due to an accident
  • Burns
• Infections: Polydipsia can also be seen in the case of a severe infection like sepsis. Sepsis is a life-threatening condition where the infection spreads in the bloodstream, thus it is also known as blood poisoning.
• Mental disorders: When polydipsia is seen in patients with mental disorders, it is called psychogenic polydipsia. These people ingest enormous amounts of water without any physiologic demand. Some of these mental disorders that can cause excessive thirst are:
  • Schizophrenia: It is a mental disorder where the person feels that they have lost touch with reality. Polydipsia is a very common sign in people with schizophrenia.
  • Intellectual disability: Previously known as mental retardation, a person is said to have an intellectual disability if they lack the ability to perform daily life functions and have a below-average intelligence quotient.
  • Bipolar disorder: Polydipsia is seen in people with bipolar disorder. They suffer from intense mood swings which include emotional lows and highs. 
  • Anxiety and depression: To cope with their anxiety, loneliness and depression, people sometimes indulge in compulsive water drinking. 
• Drug reaction: Medications like diuretics, vitamin K and corticosteroids (steroids) increases the frequency of urination. Thus, the person feels the need to drink lots of water.
  There are some medications - like diuretics (used for treating conditions like high blood pressure and kidney disease), beta-blockers (used for treating conditions like heart diseases and high blood pressure), antidepressants, antihistamines (for allergies) and antipsychotics - that lead to xerostomia or drying of the mouth. People taking these medicines also tend to drink lots of water.

Read more: Ayurvedic remedies for diabetes

In order to diagnose the underlying condition, the doctor may ask you some questions like:

• How frequently do you feel thirsty or how many times do you drink water in an hour or so?
• Do you have any other symptoms like low energy (lethargy) along with the thirst?
• When do you usually feel thirsty - while working or after doing a certain activity?
• How do you feel after drinking more than 64 ounces - or nearly two litres - of water?

The doctor may also perform some tests to confirm the underlying conditions:

• Blood glucose levels: The blood sugar test will help in determining the blood glucose levels before and after eating food.
• Urine analysis: This test will help in determining the leakage of proteins or glucose in the urine.
• Fluid deprivation test: This test is done to determine if the person has diabetes insipidus.

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The treatment of the polydipsia is based upon the underlying condition:

• Diabetes mellitus is treated with oral and injectable insulin therapy along with eating healthy, maintaining weight and doing exercises for diabetes.
• Diabetes insipidus is usually managed with the help of a hormone called desmopressin along with diuretics to control the amount of urine production and reduce thirst.
• Severe cases of dehydration and loss of fluids are treated by giving intravenous fluids. People should drink lots of water not only during summers but also winters to prevent dehydration.
• The mental disorders are treated with the help of behavioural therapy and medications like antianxiety drugs and antipsychotic drugs.
• Doctors may change the medications which cause dry mouth. If the medication cannot be changed, medicine like pilocarpine may be prescribed to the person to initiate the production of saliva. Lozenges can also be given to the person for saliva stimulation.